Abstract:
Background: Dyslipidemia is the presence of abnormal blood
lipid parameters, characterized by increased LDL-C, triglycerides,
and total cholesterol but reduced HDL-C. It is a common finding
in patients with T2DM, occurring at a prevalence rate of between
70% and 85%, and promotes the development of long-term
cardiovascular complications, which are the leading cause of
mortality in this population. Statins are the first-line drugs, but
lipid control varies from patient to patient despite being widely
used.
Objective: To assess lipid control and the factors associated with
LDL-C control in patients with type 2 DM who are on statins at a
national referral hospital in Western Kenya.
Methods: A retrospective study on 211 patients with type 2 DM
who had been on a statin for at least three months. Data was
obtained from patient records and lipid measures categorized as
controlled or uncontrolled based on the Kenya National
Guidelines for the Management of Diabetes Mellitus, 2018. Chi-
square and Fischer’s exact test determined the association between
variables. A multivariate logistic regression model was fit for
variables significant at the bivariate level, and a P value of <0.05
was considered significant.
Results: Most (99%) were on a single lipid-lowering drug, mainly
atorvastatin, and 92% were on moderate-intensity dosing.
Regarding lipid control, 50.3% had uncontrolled LDL-C, 30% had
uncontrolled HDL-C, and 47% had uncontrolled triglyceride
levels. Being on a high-intensity statin increased the likelihood of
LDL-C control compared to moderate-intensity dosing (OR 8.57
[95% CI 4.3-16.9, P<0.001]).
Conclusion: LDL-C was the most poorly controlled parameter.
Patients on high-intensity statins had better LDL-C control;
therefore, high-intensity statin therapy should be initiated in
diabetic patients who do not achieve their LDL-C targets.
