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Impact of the 2019 European Guidelines on Diabetes in Clinical Practice: Real and Simulated Analyses of Lipid Goals

Background: Recent European guidelines on diabetes, prediabetes, and cardiovascular disease developed for the European Society of Cardiology (ESC) in collaboration with the European Association for the Study of Diabetes (EASD) significantly changed some concepts on risk stratification, lipid goals,...

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Autores principales: Masson, Walter, Huerín, Melina, Lobo, Lorenzo Martin, Masson, Gerardo, Molinero, Graciela, Nemec, Mariano, Boccadoro, Mariela, Romero, Cinthia, Micali, Gabriel, Siniawski, Daniel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7151003/
https://www.ncbi.nlm.nih.gov/pubmed/32033316
http://dx.doi.org/10.3390/jcdd7010006
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author Masson, Walter
Huerín, Melina
Lobo, Lorenzo Martin
Masson, Gerardo
Molinero, Graciela
Nemec, Mariano
Boccadoro, Mariela
Romero, Cinthia
Micali, Gabriel
Siniawski, Daniel
author_facet Masson, Walter
Huerín, Melina
Lobo, Lorenzo Martin
Masson, Gerardo
Molinero, Graciela
Nemec, Mariano
Boccadoro, Mariela
Romero, Cinthia
Micali, Gabriel
Siniawski, Daniel
author_sort Masson, Walter
collection PubMed
description Background: Recent European guidelines on diabetes, prediabetes, and cardiovascular disease developed for the European Society of Cardiology (ESC) in collaboration with the European Association for the Study of Diabetes (EASD) significantly changed some concepts on risk stratification, lipid goals, and recommendations for the use of lipid-lowering drugs. The objectives of this work were to describe the lipid-lowering treatment prescribed for patients with diabetes and to determine the percentage of patients that achieved the lipid goals recommended by the 2019 ESC/EASD Guidelines on Diabetes in real and simulated scenarios. Methods: A multicenter, cross-sectional study was performed. Subjects >18 years with type 2 diabetes were included. The recommendations of the 2019 ESC/EASD Guidelines were followed. The real and simulated (ideal setting using adequate doses of statins ± ezetimibe) scenarios were analyzed. Results: Overall, 528 patients were included. In total, 62.5% of patients received statins (17.1% high intensity). Most patients were stratified as “very high risk” (54.2%) or “high risk” (43.4%). Only 13.3% achieved the double lipid goal (LDL-C and non-HDL-C goals according to the risk categories). In the simulation analysis, the proportion of subjects that did not reach the therapeutic objective decreased in all risk strata, although a considerable proportion of subjects persisted outside the target. Conclusion: The difficulty of achieving lipid goals in diabetic patients was considerable when applying the new guidelines. The situation would improve if we optimized treatment, but the prescription of new lipid-lowering drugs could be limited by their high cost.
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spelling pubmed-71510032020-04-20 Impact of the 2019 European Guidelines on Diabetes in Clinical Practice: Real and Simulated Analyses of Lipid Goals Masson, Walter Huerín, Melina Lobo, Lorenzo Martin Masson, Gerardo Molinero, Graciela Nemec, Mariano Boccadoro, Mariela Romero, Cinthia Micali, Gabriel Siniawski, Daniel J Cardiovasc Dev Dis Article Background: Recent European guidelines on diabetes, prediabetes, and cardiovascular disease developed for the European Society of Cardiology (ESC) in collaboration with the European Association for the Study of Diabetes (EASD) significantly changed some concepts on risk stratification, lipid goals, and recommendations for the use of lipid-lowering drugs. The objectives of this work were to describe the lipid-lowering treatment prescribed for patients with diabetes and to determine the percentage of patients that achieved the lipid goals recommended by the 2019 ESC/EASD Guidelines on Diabetes in real and simulated scenarios. Methods: A multicenter, cross-sectional study was performed. Subjects >18 years with type 2 diabetes were included. The recommendations of the 2019 ESC/EASD Guidelines were followed. The real and simulated (ideal setting using adequate doses of statins ± ezetimibe) scenarios were analyzed. Results: Overall, 528 patients were included. In total, 62.5% of patients received statins (17.1% high intensity). Most patients were stratified as “very high risk” (54.2%) or “high risk” (43.4%). Only 13.3% achieved the double lipid goal (LDL-C and non-HDL-C goals according to the risk categories). In the simulation analysis, the proportion of subjects that did not reach the therapeutic objective decreased in all risk strata, although a considerable proportion of subjects persisted outside the target. Conclusion: The difficulty of achieving lipid goals in diabetic patients was considerable when applying the new guidelines. The situation would improve if we optimized treatment, but the prescription of new lipid-lowering drugs could be limited by their high cost. MDPI 2020-02-05 /pmc/articles/PMC7151003/ /pubmed/32033316 http://dx.doi.org/10.3390/jcdd7010006 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Masson, Walter
Huerín, Melina
Lobo, Lorenzo Martin
Masson, Gerardo
Molinero, Graciela
Nemec, Mariano
Boccadoro, Mariela
Romero, Cinthia
Micali, Gabriel
Siniawski, Daniel
Impact of the 2019 European Guidelines on Diabetes in Clinical Practice: Real and Simulated Analyses of Lipid Goals
title Impact of the 2019 European Guidelines on Diabetes in Clinical Practice: Real and Simulated Analyses of Lipid Goals
title_full Impact of the 2019 European Guidelines on Diabetes in Clinical Practice: Real and Simulated Analyses of Lipid Goals
title_fullStr Impact of the 2019 European Guidelines on Diabetes in Clinical Practice: Real and Simulated Analyses of Lipid Goals
title_full_unstemmed Impact of the 2019 European Guidelines on Diabetes in Clinical Practice: Real and Simulated Analyses of Lipid Goals
title_short Impact of the 2019 European Guidelines on Diabetes in Clinical Practice: Real and Simulated Analyses of Lipid Goals
title_sort impact of the 2019 european guidelines on diabetes in clinical practice: real and simulated analyses of lipid goals
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7151003/
https://www.ncbi.nlm.nih.gov/pubmed/32033316
http://dx.doi.org/10.3390/jcdd7010006
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