Lipid profile of patients with uncontrolled type 2 diabetes mellitus at a tertiary South African hospital

Abstract

Introduction: Patients with type 2 diabetes mellitus (T2DM) are at very high risk of cardiovascular disease (CVD). All modifiable risk factors for CVD, especially dyslipidaemia, need to be screened for and managed.

Objective: The primary objective was to determine lipid profiles of patients with uncontrolled T2DM. The secondary objectives was to determine whether patients were achieving a target low density lipoprotein cholesterol (LDL-C) level, and whether statin choice and dosing were appropriate.

Methods: A retrospective review of files at Helen Joseph Hospital diabetic clinic.

Results: 229 patients with poorly controlled T2DM (HbA1c > 8%) were studied. The prevalence of dyslipidaemia was 93.01% (n = 213/229). In the primary prevention group, 61.84% of females and 60.47% of males did not achieve target LDL-C < 1.8 mmol/L. In the secondary prevention group, 66.67% of females and 83.33% of males did not achieve target LDL-C < 1.4 mmol/L. Statin therapy was prescribed for 86% (n = 197) of patients. No correlation was found between HbA1c and different lipid parameters.

Conclusion: This study highlights the suboptimal lipid targets achieved by patients at a specialised diabetic clinic in South Africa. A combination of factors including clinical inertia, clinician knowledge of lipid targets, and a lack of second line lipid therapy needs to be addressed.