Endocrine Abstracts

Introduction: Dyslipidemia is highly prevalent in patients with type 2 diabetes, which increases the risk of cardiovascular disease in these patients. Lipid-lowering treatment has demonstrated beneficial effects in the primary and secondary prevention of cardiovascular events.

Objective: Evaluate the therapeutic compliance of dyslipidemia treatment in type 2 diabetic patients and identify the factors limiting the follow-up of the therapeutic prescription in them.

Materials and Methods: It was a cross-sectional study, including 60 patients with type 2 diabetes hospitalized in the department C of the National Institute of Nutrition of Tunis for 3 months (October-December 2022).

Results: The mean age was 51.67 ±12.5 years. The sex ratio was 0.3. The mean duration of diabetes was 11.1±6.1 years. One third of patients were treated with insulin (30.4%). Cardiovascular risk was moderate, high, and very high in 17.9%, 50% and 32.1% of patients, respectively. Among all participants, mixed- dyslipidemia was the most prevalent (52.2%), followed by hypercholesterolemia (27.6%) while hypertriglyceridemia was identified in 20.2% of patients. Dyslipidemia was treated with atorvastatin in 82.1% of cases. In primary prevention, no patient reached the therapeutic goals, whereas in secondary prevention, the objectives were reached in only 13.2% of cases. Only 46.4% of patients reported following the clinical and biological monitoring rhythm after starting a statin treatment. More than half of the patients (56.5%) reported stopping treatment on their own. The main reasons for non-adherence to statin therapy were high cost, unavailability of treatment, side effects, and poly-medication reported in 46.2%, 23.1%, 7.7%, and 23.1% of cases, respectively. However, two thirds of patients receiving statins were not informed about their effectiveness in cardiovascular protection.

Conclusion: Non-adherence to lipid-lowering treatment in type 2 diabetic patients is a limiting factor in therapeutic efficacy. Strengthening therapeutic education for these patients would be essential to improve adherence to medical prescriptions and prevent cardiovascular events in this at-risk population.