The management of dyslipidaemia in patients with type 2 diabetes mellitus receiving lipid-lowering drugs: a sub-analysis of the CEPHEUS findings.

Background: Dyslipidaemia is a risk factor for macrovascular complications in patients with type 2 diabetes mellitus (T2DM). Our aim was to assess the use of lipid lowering drugs (LLDs) in patients with T2DM and co-existing dyslipidaemia. Method: A multicentre, non-interventional survey conducted in 6 Middle Eastern countries (Bahrain, Oman, Qatar, United Arab Emirates, Kingdom of Saudi Arabia and Kuwait). Patients with T2DM (n = 3338) taking LLD treatment for >= 3 months with no dose change for >= 6 weeks were enrolled. Results: The mean age (SD) of T2DM patients was 56.6 +/- 110.6 years; the majority (99 A) were on statin monotherapy. Only 48% of these patients achieved their low density lipoprotein cholesterol (LDL-C) goal and 67.7/0 of the patients had a high cardiovascular disease (CVD) risk according to the National Cholesterol Education Program (NCEP) Adult Treatment Panel (ATP) III guidelines. Of those who achieved LDL-C goals (n=1589), approximately one-third were at very high CVD risk and the patients who had received statin monotherapy showed the highest proportion in LDL-C goal attainment, followed by those treated with fibrate monotherapy. In a multivariate logistic regression model, taking drugs daily (odds ratio, OR: 1.64, 95 A CI 1.25, 2.15) and older age (OR: 1.09, 95 A CI 1.01, 1.18) were significantly associated with better odds of attaining LDL-C target. In contrast, patients with higher levels of ApoAl (OR: 0.73, 95 A CI [0.67,0.79]), Metabolic Syndrome (OR: 0.64, 95 A CI [0.53, 0.76]), higher CV risk (OR: 0.33, 95 A CI 0.27, 0.41), those who forgot to take their medication (OR: 0.74, 95% CI 0.62,0.88) and those who stopped taking medication when cholesterol became normal (OR: 0.67, 95 A CI 0.55,0.82) were significantly associated with lower odds of attaining LDL-C target. Conclusion: The results of this study highlight the suboptimal management of dyslipidaemia in T2DM patients at high and very high risk of CVD.