Real-life achievement of lipid-lowering treatment targets in the DIAbetes and LifEstyle Cohort Twente: Systemic assessment of pharmacological and nutritional factors

Christina M. Gant, S.H. Binnenmars, M Harmelink, Sabita Soedamah-Muthu, Stephan J L Bakker, Gerjan J Navis, Gozewijn D. Laverman

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Abstract

Background/objectives:
Lowering low-density lipoprotein cholesterol (LDLc) in type 2 diabetes mellitus is of paramount importance in preventing cardiovascular disease. However, treatment targets for LDLc are often not reached. We studied the prevalence of LDLc target achievement in a real-life population of type 2 diabetes mellitus patients in secondary care, and investigated whether in those not on target, there is room for intensifying pharmacological and lifestyle management according to current treatment guidelines.
Subjecta/methods:
We performed a cross-sectional analysis in the DIAbetes and LifEstyle Cohort Twente-1 (DIALECT-1; n = 450, age 63 ± 9 years, 58% men, diabetes duration 11 (7-18) years). At baseline, we determined plasma LDLc concentration, pharmacological treatment (i.e., statin use), and lifestyle (physical activity and dietary intake). Patients were divided according to LDLc < 1.8, LDLc 1.8-2.5, and LDLc > 2.5 mmol/l. Dietary intake was collected from a validated Food Frequency Questionnaire (177 items) and we determined guideline adherence for different food groups. Physical activity was assessed with the Short Questionnaire to ASsess Health enhancing behavior.RESULTS:LDLc data were available in 428 type 2 diabetes mellitus patients. LDLc ≤ 2.5 mmol/l was achieved in 317 patients (76%). In total, 76% of patients used statins, in those with LDLc > 2.5 mmol/l, this was 44%. Adherence to lifestyle guidelines was not different between the LDLc groups and was as follows: body mass index 6%, physical activity 59%, vegetables 7%, fruit 28%, legumes 59%, nuts 14%, dairy 19%, fish 36%, tea 8%, fats 66%, red meat 12%, processed meat 2%, alcohol 71%, sweetened beverages 34%, and sodium 12%.
Conclusions:
In type 2 diabetes mellitus patients in secondary health care, the target LDLc is achieved by three quarters of patients. Increasing statin treatment could be a first step to improve LDLc. In addition, there are ample opportunities for lifestyle management through increasing adherence to lifestyle guidelines.
Original languageEnglish
Article number24
Number of pages10
JournalNutrition & Diabetes
Volume8
Issue number1
DOIs
Publication statusPublished - 2018

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Nutrition Assessment
LDL Cholesterol
Lipids
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Type 2 Diabetes Mellitus
Exercise
Guideline Adherence
Nuts
Fishes
Body Mass Index
Cross-Sectional Studies
Alcohols
Delivery of Health Care

Keywords

  • ACUTE CORONARY SYNDROMES
  • C-REACTIVE PROTEIN
  • CARDIOVASCULAR RISK-FACTORS
  • CHRONIC KIDNEY-DISEASE
  • CLINICAL-PRACTICE
  • DENSITY-LIPOPROTEIN CHOLESTEROL
  • MONOCLONAL-ANTIBODY
  • PRIMARY PREVENTION
  • RANDOMIZED CONTROLLED-TRIAL
  • STATIN THERAPY

Cite this

Gant, Christina M. ; Binnenmars, S.H. ; Harmelink, M ; Soedamah-Muthu, Sabita ; Bakker, Stephan J L ; Navis, Gerjan J ; Laverman, Gozewijn D. / Real-life achievement of lipid-lowering treatment targets in the DIAbetes and LifEstyle Cohort Twente : Systemic assessment of pharmacological and nutritional factors. In: Nutrition & Diabetes. 2018 ; Vol. 8, No. 1.
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title = "Real-life achievement of lipid-lowering treatment targets in the DIAbetes and LifEstyle Cohort Twente: Systemic assessment of pharmacological and nutritional factors",
abstract = "Background/objectives:Lowering low-density lipoprotein cholesterol (LDLc) in type 2 diabetes mellitus is of paramount importance in preventing cardiovascular disease. However, treatment targets for LDLc are often not reached. We studied the prevalence of LDLc target achievement in a real-life population of type 2 diabetes mellitus patients in secondary care, and investigated whether in those not on target, there is room for intensifying pharmacological and lifestyle management according to current treatment guidelines.Subjecta/methods:We performed a cross-sectional analysis in the DIAbetes and LifEstyle Cohort Twente-1 (DIALECT-1; n = 450, age 63 ± 9 years, 58{\%} men, diabetes duration 11 (7-18) years). At baseline, we determined plasma LDLc concentration, pharmacological treatment (i.e., statin use), and lifestyle (physical activity and dietary intake). Patients were divided according to LDLc < 1.8, LDLc 1.8-2.5, and LDLc > 2.5 mmol/l. Dietary intake was collected from a validated Food Frequency Questionnaire (177 items) and we determined guideline adherence for different food groups. Physical activity was assessed with the Short Questionnaire to ASsess Health enhancing behavior.RESULTS:LDLc data were available in 428 type 2 diabetes mellitus patients. LDLc ≤ 2.5 mmol/l was achieved in 317 patients (76{\%}). In total, 76{\%} of patients used statins, in those with LDLc > 2.5 mmol/l, this was 44{\%}. Adherence to lifestyle guidelines was not different between the LDLc groups and was as follows: body mass index 6{\%}, physical activity 59{\%}, vegetables 7{\%}, fruit 28{\%}, legumes 59{\%}, nuts 14{\%}, dairy 19{\%}, fish 36{\%}, tea 8{\%}, fats 66{\%}, red meat 12{\%}, processed meat 2{\%}, alcohol 71{\%}, sweetened beverages 34{\%}, and sodium 12{\%}.Conclusions:In type 2 diabetes mellitus patients in secondary health care, the target LDLc is achieved by three quarters of patients. Increasing statin treatment could be a first step to improve LDLc. In addition, there are ample opportunities for lifestyle management through increasing adherence to lifestyle guidelines.",
keywords = "ACUTE CORONARY SYNDROMES, C-REACTIVE PROTEIN, CARDIOVASCULAR RISK-FACTORS, CHRONIC KIDNEY-DISEASE, CLINICAL-PRACTICE, DENSITY-LIPOPROTEIN CHOLESTEROL, MONOCLONAL-ANTIBODY, PRIMARY PREVENTION, RANDOMIZED CONTROLLED-TRIAL, STATIN THERAPY",
author = "Gant, {Christina M.} and S.H. Binnenmars and M Harmelink and Sabita Soedamah-Muthu and Bakker, {Stephan J L} and Navis, {Gerjan J} and Laverman, {Gozewijn D.}",
year = "2018",
doi = "10.1038/s41387-018-0028-y",
language = "English",
volume = "8",
journal = "Nutrition & Diabetes",
issn = "2044-4052",
publisher = "Nature Publishing Group",
number = "1",

}

Real-life achievement of lipid-lowering treatment targets in the DIAbetes and LifEstyle Cohort Twente : Systemic assessment of pharmacological and nutritional factors. / Gant, Christina M.; Binnenmars, S.H.; Harmelink, M; Soedamah-Muthu, Sabita; Bakker, Stephan J L; Navis, Gerjan J; Laverman, Gozewijn D.

In: Nutrition & Diabetes, Vol. 8, No. 1, 24, 2018.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - Real-life achievement of lipid-lowering treatment targets in the DIAbetes and LifEstyle Cohort Twente

T2 - Systemic assessment of pharmacological and nutritional factors

AU - Gant, Christina M.

AU - Binnenmars, S.H.

AU - Harmelink, M

AU - Soedamah-Muthu, Sabita

AU - Bakker, Stephan J L

AU - Navis, Gerjan J

AU - Laverman, Gozewijn D.

PY - 2018

Y1 - 2018

N2 - Background/objectives:Lowering low-density lipoprotein cholesterol (LDLc) in type 2 diabetes mellitus is of paramount importance in preventing cardiovascular disease. However, treatment targets for LDLc are often not reached. We studied the prevalence of LDLc target achievement in a real-life population of type 2 diabetes mellitus patients in secondary care, and investigated whether in those not on target, there is room for intensifying pharmacological and lifestyle management according to current treatment guidelines.Subjecta/methods:We performed a cross-sectional analysis in the DIAbetes and LifEstyle Cohort Twente-1 (DIALECT-1; n = 450, age 63 ± 9 years, 58% men, diabetes duration 11 (7-18) years). At baseline, we determined plasma LDLc concentration, pharmacological treatment (i.e., statin use), and lifestyle (physical activity and dietary intake). Patients were divided according to LDLc < 1.8, LDLc 1.8-2.5, and LDLc > 2.5 mmol/l. Dietary intake was collected from a validated Food Frequency Questionnaire (177 items) and we determined guideline adherence for different food groups. Physical activity was assessed with the Short Questionnaire to ASsess Health enhancing behavior.RESULTS:LDLc data were available in 428 type 2 diabetes mellitus patients. LDLc ≤ 2.5 mmol/l was achieved in 317 patients (76%). In total, 76% of patients used statins, in those with LDLc > 2.5 mmol/l, this was 44%. Adherence to lifestyle guidelines was not different between the LDLc groups and was as follows: body mass index 6%, physical activity 59%, vegetables 7%, fruit 28%, legumes 59%, nuts 14%, dairy 19%, fish 36%, tea 8%, fats 66%, red meat 12%, processed meat 2%, alcohol 71%, sweetened beverages 34%, and sodium 12%.Conclusions:In type 2 diabetes mellitus patients in secondary health care, the target LDLc is achieved by three quarters of patients. Increasing statin treatment could be a first step to improve LDLc. In addition, there are ample opportunities for lifestyle management through increasing adherence to lifestyle guidelines.

AB - Background/objectives:Lowering low-density lipoprotein cholesterol (LDLc) in type 2 diabetes mellitus is of paramount importance in preventing cardiovascular disease. However, treatment targets for LDLc are often not reached. We studied the prevalence of LDLc target achievement in a real-life population of type 2 diabetes mellitus patients in secondary care, and investigated whether in those not on target, there is room for intensifying pharmacological and lifestyle management according to current treatment guidelines.Subjecta/methods:We performed a cross-sectional analysis in the DIAbetes and LifEstyle Cohort Twente-1 (DIALECT-1; n = 450, age 63 ± 9 years, 58% men, diabetes duration 11 (7-18) years). At baseline, we determined plasma LDLc concentration, pharmacological treatment (i.e., statin use), and lifestyle (physical activity and dietary intake). Patients were divided according to LDLc < 1.8, LDLc 1.8-2.5, and LDLc > 2.5 mmol/l. Dietary intake was collected from a validated Food Frequency Questionnaire (177 items) and we determined guideline adherence for different food groups. Physical activity was assessed with the Short Questionnaire to ASsess Health enhancing behavior.RESULTS:LDLc data were available in 428 type 2 diabetes mellitus patients. LDLc ≤ 2.5 mmol/l was achieved in 317 patients (76%). In total, 76% of patients used statins, in those with LDLc > 2.5 mmol/l, this was 44%. Adherence to lifestyle guidelines was not different between the LDLc groups and was as follows: body mass index 6%, physical activity 59%, vegetables 7%, fruit 28%, legumes 59%, nuts 14%, dairy 19%, fish 36%, tea 8%, fats 66%, red meat 12%, processed meat 2%, alcohol 71%, sweetened beverages 34%, and sodium 12%.Conclusions:In type 2 diabetes mellitus patients in secondary health care, the target LDLc is achieved by three quarters of patients. Increasing statin treatment could be a first step to improve LDLc. In addition, there are ample opportunities for lifestyle management through increasing adherence to lifestyle guidelines.

KW - ACUTE CORONARY SYNDROMES

KW - C-REACTIVE PROTEIN

KW - CARDIOVASCULAR RISK-FACTORS

KW - CHRONIC KIDNEY-DISEASE

KW - CLINICAL-PRACTICE

KW - DENSITY-LIPOPROTEIN CHOLESTEROL

KW - MONOCLONAL-ANTIBODY

KW - PRIMARY PREVENTION

KW - RANDOMIZED CONTROLLED-TRIAL

KW - STATIN THERAPY

U2 - 10.1038/s41387-018-0028-y

DO - 10.1038/s41387-018-0028-y

M3 - Article

VL - 8

JO - Nutrition & Diabetes

JF - Nutrition & Diabetes

SN - 2044-4052

IS - 1

M1 - 24

ER -