Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Diabetes Metab J. 2011 Dec;35(6):628-36. doi: 10.4093/dmj.2011.35.6.628. Epub 2011 Dec 26.
This study aims to investigate the discrepancy between clinicians' perceptions and actual achievement rates of low density lipoprotein cholesterol (LDL-C) in Korean patients with diabetes according to updated American Diabetes Association (ADA)/American College of Cardiology Foundation (ACC) recommendations.
This is a multi-center, retrospective, non-interventional, observational study. Diabetic patients aged 18 years or older were eligible if they had been diagnosed with hypercholesterolemia or were receiving a lipid-lowering therapy between May 2010 and August 2010. The information was obtained by reviewing medical records and using a self-completed questionnaire to examine physician perceptions.
A total of 2,591 subjects who satisfied the inclusion criteria were enrolled. Highest-risk and high-risk patients accounted for 61.9% and 38.1% of the patients, respectively. Although most (96.3%) underwent a statin monotherapy or a statin-based combination therapy, just 47.4% of patients attained the LDL-C target. However, the physicians' perceptions on target achievement rate (70.6%) were different from the actual results (47.4%). Many patients (65.3%) remained on the starting doses of statins, despite evidence of poor achievement of lipid goals.
Only less than half of patients with diabetes attained the LDL-C goal. The surveys showed that poor physician performance might be due to the lack of recognition on ADA/ACC consensus causing a low LDL-C target attainment rate. Therefore, changes in doctor perception are needed to attain target LDL-C level and reduce cardiovascular risk in Korean patients with diabetes.
本研究旨在根据美国糖尿病协会(ADA)/美国心脏病学会基金会(ACC)的最新建议,调查韩国糖尿病患者的临床医生对低密度脂蛋白胆固醇(LDL-C)的认知与实际达标率之间的差异。
这是一项多中心、回顾性、非干预性、观察性研究。年龄在 18 岁或以上的糖尿病患者,如果在 2010 年 5 月至 2010 年 8 月期间被诊断为高胆固醇血症或正在接受降脂治疗,则符合入选条件。通过查阅病历和使用自我完成的问卷来检查医生的认知,获取信息。
共有 2591 名符合纳入标准的患者入选。高危和高风险患者分别占患者的 61.9%和 38.1%。尽管大多数(96.3%)接受了他汀类药物单一疗法或他汀类药物联合治疗,但只有 47.4%的患者达到了 LDL-C 目标。然而,医生对目标达标率(70.6%)的认知与实际结果(47.4%)不同。尽管血脂目标达标情况较差,但许多患者(65.3%)仍在使用他汀类药物的起始剂量。
只有不到一半的糖尿病患者达到了 LDL-C 目标。调查显示,医生表现不佳可能是由于缺乏对 ADA/ACC 共识的认识,导致 LDL-C 目标达标率较低。因此,需要改变医生的认知,以达到目标 LDL-C 水平并降低韩国糖尿病患者的心血管风险。