Control of Diabetic Dyslipidemia among Type-II Diabetics in Western Region of the Republic of Macedonia

Abstract

Background: Serum lipids are poorly controlled in most European countries and the control rate is even lower in diabetic patients. All international guidelines recommend aggressive management of lipids in this population. To date, evidence on whether diabetic dyslipidemia is adequately managed or not in western region of the Republic of Macedonia are scarce. Objective: To determine the degree of dyslipidemia control in diabetics patients, according to evidence and current guidelines, by primary healthcare physicians, in our region. Methods: This is a multicenter, non-interventional, observational study. Prospectively tested were 555 participants. The study was conducted at outpatient in Primary Health Care Clinics in 8 towns, on western region Republic of Macedonia. Study participants were selected among primary care patient, who were receiving ongoing care for diabetes mellitus type-2(T2DM) and dyslipidemia, during 1 calendar year. We recorded information from all healthcare encounters during 1 calendar year. Results: Our study showed that among diabetic patients with overt cardio-vascular disease(CVD), target LDL-C level of ( < 70 mg/dL),was achieved in 21.4% of patients, whereas 78.6% of patient did not achieved target LDL-C level, respectively.(p=.0000). Among diabetic patients without overt CVD, target LDL-C level of (< 100 mg/dL) was achieved in 44.2% of patients, whereas 55.7% of patients did not achieved target LDL-C level, respectively (p=.06). It was observed that, only 36.7% of the total study population, had achieved LDL-C goals according to evidence and current guidelines, whereas 63.3% of patients did not achieved target LDL-C level, despite an ongoing medical treatment, respectively.(p= .0000). Among the total study population (N=555), target LDL-C level was achieved in 14.0% of the female patients and in 47.3% of the male patients, respectively. (p=.002). Age, BMI and Duration of T2DM, were significantly associated with uncontrolled LDL-C level, according to evidence and current guidelines. (Age: OR=1.214; 95%CI 1.165-1.1263; p=.000; BMI: OR=1.270; 95% CI 1.203-1.341; p=.000; Duration of T2DM: OR=1.035; 95% CI 0.950-1.121;p=.036). Conclusions: Control rates of dyslipidemia among T2DM patients, in the western region of the Republic of Macedonia, continue to be alarmingly low, particularly in women. It is clear that aggressive dyslipidemia management is the need of the hour in patients with diabetes.