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

Research output: Contribution to journalArticleScientificpeer-review

5 Citations (Scopus)

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

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

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