Endocrine Abstracts

Background

Diabetes is often associated with other cardiovascular (CV) risk factors such as dyslipidemia, wich increases the risk of degenerative disease and contributes to elevate morbi-mortality in these patients. The aim of this study was to assess the CV risk level of diabetic patients and to determine the rate of lipid targets achievement.

Methods

it was a descriptive cross-sectional study including 100 diabetic. CV risk levels and low- density lipoprotein cholesterol (LDL-C) goal achievements were performed according to ESC’s guidelines updated in 2019.

Results

The mean age was 50 ± 10.6 years with a predominance of females (52.8%). All patients had dyslipidemia associated with type 1 (72.8%) or type 2 (27.8%) diabetes. The most common type was mixed dyslipidemia (47.2%), followed by pure hypertriglyceridemia (38.9%) and only 13.9% had pure hypercholesterolemia. According to new guidelines, 37.8% and 62.2% were considered as very high and high CV risk, respectively. Most patients at very high cardiovascular risk (82%) had complicated diabetes. These complications were represented by diabetic retinopathy (65.4%) and diabetic kidney disease (34.6%). The other patients had cardiovascular disease established clinically or by imaging (18%), namely coronary artery disease (6%), stroke or transient ischemic attack (1.2%) and arterial occlusive disease of the lower limbs (10.8%). Less than half of the patients achieved their recommended LDL-c goals (38.3%). According to the CV risk level, only 12.1% and 26.2% met their goals for very high risk and high risk, respectively. Non-achievement of LDL-c goals was significantly associated with discontinuation of treatment (P < 0.001). In 2/3 of cases, it was explained by the non-availability of lipid-lowering treatment in dispensaries. Among the patients who did not reach their LDL-c goals, poorly adapted dosage and treatment were observed in 48.3% and 32.3% of cases respectively (P = 0.04).

Conclusions

Despite of high CV risk levels, most of patients didn’t achieve recommended goals. This is likely to be due to either discontinuation of medications or therapeutic inertia.