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弥合证据与实践之间的差距:对500万2型糖尿病患者降脂治疗处方模式的全国性回顾性分析

Bridging the Gap between Evidence and Practice: Nationwide Retrospective Analysis of Lipid-Modifying Therapy Prescription Patterns in 5 Million Patients with Type 2 Diabetes Mellitus.

作者信息

Hassan Ahmed, Keshk Menna A, Reyad Mohamed, Ahmed Nourhan, Nassar Omar, Siraj Aisha, Badr Salem, Eltawansy Sherif, Misra Anoop, Essibayi Muhammed Amir, Azzam Ahmed Y, Nassar Mahmoud, Hakim Diaa

机构信息

Department of Cardiology, Suez Medical Complex, Ministry of Health and Population, Suez, Egypt.

Faculty of Medicine, Cairo University, Cairo, Egypt.

出版信息

ASIDE Intern Med. 2026 Apr 1;2(2):6-11. doi: 10.71079/aside.im.08252522. Epub 2025 Aug 25.

DOI:10.71079/aside.im.08252522
PMID:40949177
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12425125/
Abstract

INTRODUCTION

Type 2 diabetes mellitus (T2DM) is associated with dyslipidemia and significantly increased cardiovascular risk, making lipid-modifying therapy a crucial preventive intervention in these patients. Despite clear guidelines recommending statin therapy for both primary and secondary prevention, real-world prescription routines and practices show gaps in clinical care. We aimed to evaluate the rates and patterns of lipid-modifying therapy under prescription among T2DM patients across U.S. healthcare facilities.

METHODS

We conducted a retrospective observational analysis using the TriNetX US Collaborative Network database, including data from 69 healthcare organizations throughout the United States. Patients with T2DM patients aged 40-75 years were included in our cohort. Under-prescription rates were calculated and analyzed across demographic subgroups using standardized protocols within the TriNetX platform.

RESULTS

Among 5,007,910 T2DM patients, we observed significant statin under-prescription rates. Our analysis showed a prescription rate of 55.1% for statins in eligible patients with T2DM.

CONCLUSIONS

Our findings revealed a significant under-prescription of lipid-modifying therapy in T2DM patients. The universal nature of under-prescription suggests barriers to guideline implementation. These results underscore the urgent need for systematic interventions, including automated identification systems, standardized protocols, and optimized provider education to improve cardiovascular risk management in patients with T2DM.

摘要

引言

2型糖尿病(T2DM)与血脂异常相关,心血管风险显著增加,因此降脂治疗成为这些患者至关重要的预防性干预措施。尽管有明确的指南推荐他汀类药物用于一级和二级预防,但实际临床处方常规和做法显示出临床护理方面存在差距。我们旨在评估美国医疗机构中T2DM患者处方降脂治疗的比例和模式。

方法

我们使用TriNetX美国协作网络数据库进行了一项回顾性观察分析,该数据库包含来自美国69个医疗机构的数据。年龄在40 - 75岁的T2DM患者被纳入我们的队列。在TriNetX平台内使用标准化方案计算并分析各人口统计学亚组的处方不足率。

结果

在5,007,910例T2DM患者中,我们观察到他汀类药物存在显著的处方不足率。我们的分析显示,符合条件的T2DM患者中他汀类药物的处方率为55.1%。

结论

我们的研究结果显示T2DM患者的降脂治疗存在显著的处方不足。处方不足的普遍性表明指南实施存在障碍。这些结果强调迫切需要采取系统性干预措施,包括自动识别系统、标准化方案和优化的医疗服务提供者教育,以改善T2DM患者的心血管风险管理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a823/12425125/3f290c1765ba/nihms-2108724-f0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a823/12425125/3f290c1765ba/nihms-2108724-f0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a823/12425125/3f290c1765ba/nihms-2108724-f0001.jpg

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The variability of measured and calculated low-density lipoprotein (LDL) cholesterol in statin-treated diabetes patients.
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