How well is LDL cholesterol treated in patients with type 2 Diabetes Mellitus?

Harmelink, M. (Manon) (2016) How well is LDL cholesterol treated in patients with type 2 Diabetes Mellitus? thesis, Medicine.

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Abstract

Background: Macrovascular complications are the chief cause of major morbidity and death in patients with diabetes. Dyslipidaemia increases the risk of cardiovascular disease (CVD) in patients with type 2 diabetes mellitus (T2DM). Earlier research has shown a reduction in CVD when LDL cholesterol is lowered, also in patients with diabetes mellitus. Lowering LDL cholesterol can be achieved by lipid-lowering medication, diet and physical activity. However, much remains unclear about the use of lipid-lowering medication and the contribution of lipid-lowering medication, diet and physical activity on the LDL cholesterol in patient with T2DM. Objective: This study investigates the statin use in patients with T2DM and the contribution of lipid-lowering medication, diet and physical activity on LDL cholesterol. Methods: In this cross-sectional cohort study 432 patients with T2DM from a second-line centre were included. Data were collected through questionnaires about diet and physical activity, physical examination and analyses of blood and urine samples. Body measurements, lipid-lowering medication, diet, physical activity, serum lipid profile and comorbidity were evaluated. Association between independent predictors and LDL cholesterol was assessed by multivariate regression analysis. Results: The prevalence of statin use in T2DM patients in a secondary care setting is 71.6% (n=304). Of all patients who use or have used a statin 7.1% (n=24) experience side effects. The final predictive model for LDL cholesterol includes 2 independent variables: statin use (r = -0.445) and waist circumference (r = -0.123). There was no association between diet or physical activity and LDL cholesterol. Conclusion: Our study shows that LDL cholesterol strongly dependents on statin use. With the normal diet and exercise patterns as seen in our study group, we see no impact of lifestyle. Keeping in mind the strong relation between statin use and LDL cholesterol in diabetic patients, the importance of statin use in the population is underlined. Therefore it is important not to just stop using statins. If there is an indication for statin use and a statin is not tolerated, it is important to try another statin or other lipid-lowering medication.

Item Type:	Thesis (Thesis)
Supervisor name:	Laverman, Dr. G.D.
Supervisor name:	Second supervisor: and Gant, Christina and Location: ZGT Almelo - Department Intern medicine
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 10:50
Last Modified:	25 Jun 2020 10:50
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/1073

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