Endocrine Abstracts

Background and Aim: Diabetes is often associated with other cardiovascular (CV) risk factors wich elevates morbi-mortality in these patients. Primary and secondary CV prevention depends on the control of CV risk factor including low- density lipoprotein cholesterol (LDL-C) level. 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 122 type 2 diabetes patients. All patients had mixed dyslipidemia treated by statins. CV risk level and LDL-c goal achievement were assessed according to European Society of Cardiology updated guidelines in 2021. New is the introduction of a stepwise approach to intensify preventive treatments.

Results: The mean age was 58.56±9.05 years with a female predominance (56.5%). Mean diabetes duration was 13±7.44 years, mean glycated hemoglobin was 9.9% ±1.74, 20.4% of patients used oral glucose-lowering drugs (OGLDs) only, and 79.6% used OGLDs plus insulin. Only 12.5% used insulin analogs. Microvscular complications were present in 52.1% of patients. Meam Body Mass Index was 29.53±8.07 kg/m^² ,59% of patients had high blood pressure and 22.66% were tabacco users. Mean dose of Atorvastatine was 40 mg, prescribed as secondary prevention in 13.7% of cases. According to new guidelines, 23.3% and 76.7% were considered at very high and high CV risk, respectively. Step1 LDL-c goals were achieved in 65.1% of cases while step 2 LDL-c goals were achieved in 32.1% of patients according to their CV risk level. Patients at high and very high CV risk achieved LDL-c goal level in 27.5% and 4.6% of cases respectively. Non-achievement of LDL-c goals was due to non-availibility of treatment in 40% of cases and poorly adapted dosage in 36.6% of cases.

Conclusions: Most of patients didn’t achieve recommended goals likely due to non avaibility of treatment and therapeutic inertia. The cost of treatment could explain these results as this later is a fundamental criterion in countries with low financial resources as Ezetimibe and PCSK-9 inhibitors are not available or available at high cost.