Use of non-LDL-C lipid-lowering medications in patients with type 2 diabetes

• Type of Material: Article
• Authors: Suzanne V. Arnold, Mid America Heart Institute - Kansas City; Kensey Gosch, Mid America Heart Institute - Kansas City; Nathan D. Wong, University of California Irvine; Vittal Hejjaji, Mid America Heart Institute - Kansas City; Abhinav Goyal, Emory University; Lawrence A. Leiter, Li Ka Shing Knowledge Institute; Mikhail Kosiborod, Mid America Heart Institute - Kansas City
• Language: English
• Date: 2020-07-01
• Publisher: Wiley
• Publication Version: Final Published Version
• Copyright Statement: © 2020 The Authors. Endocrinology, Diabetes & Metabolism published by John Wiley & Sons Ltd.
• Final Published Version (URL): http://dx.doi.org/10.1002/edm2.126
• Title of Journal or Parent Work: Endocrinology, Diabetes and Metabolism
• Volume: 3
• Issue: 3
• Start Page: e00126
• End Page: e00126
• Grant/Funding Information: The Diabetes Collaborative Registry is funded by AstraZeneca (founding sponsor) and Boehringer Ingelheim. Corporate sponsors had no role in data analysis or interpretation, manuscript development or in publication review or approval for this study.
• Keywords: diabetes mellitus; quality of care; triglycerides; lipids
• Research Categories: Health Sciences, Nutrition; Health Sciences, Health Care Management

Abstract

Background A number of non‐low‐density lipoprotein cholesterol lipid abnormalities are associated with type 2 diabetes and insulin resistance, which may lead practitioners to use medications targeting these abnormal lipid fractions despite a lack of evidence or guideline recommendations. Methods and Results Among 382 921 US patients with type 2 diabetes (69% with cardiovascular disease, 76% on a statin), 95 995 (26%) were on some nonstatin lipid‐lowering medication—19 265 (5%) on niacin, 32 919 (9%) on a fibrate and 69 513 (18%) on fish oil. Use of all three medications was stable over time and higher in patients with cardiovascular disease and with higher triglyceride levels, although even among patients with triglyceride levels <2.3 mmol/L, 6% were on a fibrate and 17% were on fish oil. Conclusion As clinical trials demonstrate little to no cardiovascular benefit from taking these medications, greater attention is needed to focus the use of lipid‐lowering medications to those with proven benefit.