Dyslipidemia Treatment in Diabetic Patients in a U.S. Managed Care Plan

Autor: Peter P. Toth, Sharash Shetty, Russel T. Burge, David L. Laitinen
Rok vydání: 2008
Předmět:
Zdroj: Canadian Journal of Diabetes. 32:326
ISSN: 1499-2671
DOI: 10.1016/s1499-2671(08)24107-9
Popis: Dyslipidemia Treatment in Diabetic Patients in a U.S. Managed Care Plan. PETER P TOTH*, DAVID L. LAITINEN, RUSSEL T. BURGE, SHARASH SHETTY, 1.University of Illinois College of Medicine, Peoria, IL, 2.Abbott, Abbott Park, IL, 3. i3 Innovus, Eden Prairie, MN. For diabetes mellitus patients (a population at high-risk for cardiac events, defined by NCEP as a CHD-risk equivalent), the ADA has suggested goals for serum high-density lipoprotein [HDL-C], lowdensity lipoprotein [LDL-C], non-HDL-C, and triglycerides [TG]. All commercial health plan members in a large, U.S. managed care database with complete lipid panel results (HDL-C, LDL-C, TG) between 1/1/2006 and 12/31/2006 were selected, where the index date was the date of a complete lipid panel (N = 529,236). Diabetic patients with mixed dyslipidemia (MD) were identified and defined as having any two non-optimal lipid parameters (LDL-C, HDL-C, TG) according to ADA guidelines (N = 28,728). Lipid treatment status 6 months preand post-index date was determined using pharmacy claims for any lipid therapy [statins, fibrates, niacin, “other” (cholestyramine, colestipol, colesevelam, ezetimibe), combination therapy (statin + fenofibrate; statin + niacin; statin + other)]. Treatment with any lipid-modifying therapy post-index for MD diabetics with any 2 or 3 abnormal lipids was 58.9% and 54.9%, respectively. Among those with lipid values in the most severe quartiles, treatment post-index was 57.4%, 63.6% and 66.4% for LDL-C, HDL-C and TG, respectively. When treated, the primary lipidmodifying regimen was statin monotherapy (54.8% and 47.8% for patients with any 2 and all 3 lipids not at goal, respectively). Only one-third of treated patients were given combination therapy. About 40% of diabetic patients with MD received no lipidmodifying therapy, and treated patients were primarily prescribed statin monotherapy. This study suggests diabetic patients are not being treated to ADA suggested targets. Given the low percentage of diabetic patients with MD who are treated with any lipid-modifying therapy, and the even lower percentage achieving their goals, further research is warranted to investigate how physicians tailor lipidmodifying therapy in these patients. 200
Databáze: OpenAIRE
Externí odkaz: