Attaining acceptable levels of LDL Cholesterol (LDL-C) significantly improves cardiovascular (CV) outcomes in patients with type 2 diabetes mellitus (T2DM). The LDL-C target attainment and the characteristics of patients attaining these targets were investigated in this study. Furthermore, the reasons for not choosing statins and the physicians’ attitudes on the treatment of diabetic dyslipidemia were also examined. A nationwide, cross-sectional survey was conducted in tertiary centers for diabetes management. Adult patients with T2DM, who were under follow-up for at least a year in outpatient clinics, were consecutively enrolled for the study. LDL-C goals were defined as below 70 mg/dL for patients with macrovascular complications or diabetic nephropathy, and below 100 mg/dL for other patients. Data about lipid-lowering medications were self-reported. A total of 4504 patients (female: 58.6%) were enrolled for the study. The mean HbA1c and diabetes duration was 7.73 ± 1.74% and 10.9 ± 7.5 years, respectively. The need for statin treatment was 94.9% (n = 4262); however, only 42.4% (n = 1807) of these patients were under treatment, and only 24.8% (n = 448) of these patients achieved LDL-C targets. The main reason for statin discontinuation was negative media coverage (87.5%), while only a minority of patients (12.5%) mentioned side effects. Physicians initiated lipid-lowering therapy in only 20.3% of patients with high LDL-C levels. It was observed that the female gender was a significant independent predictor of not attaining LDL-C goals (OR: 0.70, 95% CI: 0.59–0.83). Less than 50 % of patients with T2DM who need statins were under treatment, and only a quarter of them attained their LDL-C targets. There exists a significant gap between the guideline recommendations and the real-world evidence in the treatment of dyslipidemia in T2DM.

中文翻译：

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在土耳其 2 型糖尿病患者中使用他汀类药物和达到 LDL-胆固醇目标——一项全国性横断面研究（TEMD 血脂异常研究）

达到可接受的低密度脂蛋白胆固醇 (LDL-C) 水平可显着改善 2 型糖尿病 (T2DM) 患者的心血管 (CV) 结果。本研究调查了 LDL-C 目标的实现情况和达到这些目标的患者的特征。此外，还考察了不选择他汀类药物的原因和医生对糖尿病血脂异常治疗的态度。在糖尿病管理三级中心进行了一项全国性的横断面调查。在门诊随访至少一年的 T2DM 成年患者被连续纳入研究。大血管并发症或糖尿病肾病患者的 LDL-C 目标定义为低于 70 mg/dL，其他患者的 LDL-C 目标定义为低于 100 mg/dL。关于降脂药物的数据是自我报告的。共有 4504 名患者（女性：58.6%）参加了这项研究。平均 HbA1c 和糖尿病持续时间分别为 7.73 ± 1.74% 和 10.9 ± 7.5 年。他汀类药物治疗的需求为 94.9% (n = 4262)；然而，这些患者中只有 42.4% (n = 1807) 正在接受治疗，并且这些患者中只有 24.8% (n = 448) 达到了 LDL-C 目标。他汀类药物停用的主要原因是负面媒体报道 (87.5%)，而只有少数患者 (12.5%) 提到了副作用。只有 20.3% 的 LDL-C 水平高的患者被医生启动了降脂治疗。据观察，女性是未达到 LDL-C 目标的重要独立预测因素（OR：0.70，95% CI：0.59–0.83）。需要他汀类药物的 T2DM 患者中，只有不到 50% 接受治疗，其中只有四分之一达到了 LDL-C 目标。在治疗 T2DM 血脂异常方面，指南建议与现实世界证据之间存在显着差距。