Management of LDL‐cholesterol levels in patients with Diabetes Mellitus in Cardiology Practice: Real‐life evidence of Under‐treatment from the EPHESUS registry

2021 ◽  
Author(s):  
Kadir Uğur Mert ◽  
Özcan Başaran ◽  
Gurbet Özge Mert ◽  
Volkan Doğan ◽  
İbrahim Rencüzoğulları ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Ldl Cholesterol ◽  
Real Life ◽  
Cholesterol Levels ◽  
Patients With Diabetes

scholarly journals Efficacy of Lipid-Lowering Therapy During Cardiac Rehabilitation in Patients With Diabetes Mellitus and Coronary Heart Disease

2021 ◽  
Author(s):  
Thomas Wittlinger ◽  
Bernhard Schwaab ◽  
Heinz Voeller ◽  
Christa Bongarth ◽  
Viktoria Heinze ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Ldl Cholesterol ◽  
Lipid Lowering ◽  
Diabetic Patients ◽  
Lipid Lowering Therapy ◽  
Cholesterol Levels ◽  
Patients With Diabetes

Abstract BackgroundCardiac rehabilitation (CR) in patients with coronary heart disease (CHD) aims to increase adherence to a healthy lifestyle and to secondary preventive medication. CR is able to improve quality of life and prognosis in CHD patients. This is particularly relevant for CHD patients with diabetes mellitus.DesignA prospective, multicenter registry study with patients from six rehabilitation centers in Germany.MethodsDuring CR, 1100 patients with a minimum age of 18 years and CHD documented by coronary angiography were included in a LLT registry.ResultsIn 369 patients (33.9 %), diabetes mellitus was diagnosed. Diabetic patients were older (65.5 ± 9.0 vs. 62.2 ± 10.9 years, p < 0.001) than nondiabetic patients and more likely to be obese (BMI: 30.2 ± 5.2 kg/m2 vs. 27.8 ± 4.2 kg/m2, p < 0.001). Analysis indicated that diabetic patients were more likely to show LDL cholesterol levels below 55 mg/dL than patients without diabetes at the start of CR (Odds Ratio (OR) 1.9; 95 % CI 1.3 to 2.9) until 3 months of follow-up (OR 1.9; 95 % CI 1.2 to 2.9). During 12 months of follow-up, overall and LDL cholesterol levels decreased within the first 3 months and remained at the lower level thereafter (p < 0.001), irrespective of prevalent diabetes. At the end of the follow-up, LDL cholesterol did not differ significantly between patients with or without diabetes mellitus (p = 0.413).ConclusionWithin 3 months after CR, total and LDL cholesterol were significantly reduced, irrespective of prevalent diabetes mellitus. In addition, CHD patients with diabetes responded faster to LTT than nondiabetic patients, suggesting that diabetic patients benefit more from LLT treatment during CR.

scholarly journals Efficacy of Lipid-Lowering Therapy during Cardiac Rehabilitation in Patients with Diabetes Mellitus and Coronary Heart Disease

2021 ◽  
Vol 8 (9) ◽  
pp. 105
Author(s):  
Thomas Wittlinger ◽  
Bernhard Schwaab ◽  
Heinz Völler ◽  
Christa Bongarth ◽  
Viktoria Heinze ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Coronary Heart Disease ◽  
Ldl Cholesterol ◽  
Lipid Lowering ◽  
Diabetic Patients ◽  
Lipid Lowering Therapy ◽  
Cholesterol Levels ◽  
Lowering Therapy ◽  
Patients With Diabetes

Background: Cardiac rehabilitation (CR) in patients with coronary heart disease (CHD) increases adherence to a healthy lifestyle and to secondary preventive medication. A notable example of such medication is lipid-lowering therapy (LLT). LLT during CR improves quality of life and prognosis, and thus is particularly relevant for patients with diabetes mellitus, which is a major risk factor for CHD. Design: A prospective, multicenter registry study with patients from six rehabilitation centers in Germany. Methods: During CR, 1100 patients with a minimum age of 18 years and CHD documented by coronary angiography were included in a LLT registry. Results: In 369 patients (33.9%), diabetes mellitus was diagnosed. Diabetic patients were older (65.5 ± 9.0 vs. 62.2 ± 10.9 years, p < 0.001) than nondiabetic patients and were more likely to be obese (BMI: 30.2 ± 5.2 kg/m2 vs. 27.8 ± 4.2 kg/m2, p < 0.001). Analysis indicated that diabetic patients were more likely to show LDL cholesterol levels below 55 mg/dL than patients without diabetes at the start of CR (Odds Ratio (OR) 1.9; 95% CI 1.3 to 2.9) until 3 months of follow-up (OR 1.9; 95% CI 1.2 to 2.9). During 12 months of follow-up, overall and LDL cholesterol levels decreased within the first 3 months and remained at the lower level thereafter (p < 0.001), irrespective of prevalent diabetes. At the end of the follow-up period, LDL cholesterol did not differ significantly between patients with or without diabetes mellitus (p = 0.413). Conclusion: Within 3 months after CR, total and LDL cholesterol were significantly reduced, irrespective of prevalent diabetes mellitus. In addition, CHD patients with diabetes responded faster to LTT than nondiabetic patients, suggesting that diabetic patients benefit more from LLT treatment during CR.

scholarly journals The сardiometabolic assessment of the glycemic variability in patients with diabetes mellitus: the role of the glucocardiomonitoring

Kardiologiia ◽  
2020 ◽  
Vol 60 (5) ◽  
pp. 100-106
Author(s):  
N. A. Chernikova ◽  
L. L. Kamynina ◽  
A. S. Ametov
Keyword(s):  
Diabetes Mellitus ◽  
Real Life ◽  
Glycemic Variability ◽  
Holter Monitoring ◽  
Cardiac Monitoring ◽  
Qtc Interval ◽  
St Segment ◽  
Patients With Diabetes ◽  
Hypoglycemic Therapy

Aim To study quantitatively the two-way relationship between parameters of glycemic variability and development of cardiovascular events in patients with type 2 diabetes mellitus (DM) on chronic sulfonylurea (SM) therapy by synchronous, professional glucose and cardiac monitoring.Material and methods The study included 421 patients with type 2 DM on SM therapy. A 5-day synchronous glucose and cardiac monitoring was performed for these patients in a retrospective mode using an iPro2 (Medtronic, USA) continuous glycemia monitoring (CGM) system and Holter monitoring. Glycemic endpoints (CGM-parameters of glycemia variability and integral indexes) and cardiological endpoints (ventricular rhythm disorders (VRD), ST segment depression (dST), and corrected QT interval (QTc)) were evaluated.Results Clear correlations were found between the ST segment depression and the increase in TIR-HYPO index and the length of QTc. The strongest correlation was observed for VRD and the increase in TIR-HYPO. Moderate correlations were observed between VRD and the decrease in TIR-NORMO and between increased variabilities of glycemia (increases in SD and number of glycemia excursions >4 mmol/l/h) and integral indexes (mean CGM-level of glycemia and HbA1c). Elongation of the QTc interval was associated with increased TIR-HYPO, decrease in maximum glycemia, and development of dST.Conclusion The glucose and cardiac monitoring confirmed the close interrelation between the quality of glycemic control and cardiovascular disorders and should be recommended for a wider use in real-life clinical practice for determining the cardiometabolic status of patients and personalization of hypoglycemic therapy.

scholarly journals FEATURES OF DYSLIPOPROTEINEMIA IN TYPE 2 DIABETES MELLITUS PATIENTS WITH PRIOR MYOCARDIAL INFARCTION

2020 ◽  
Vol 16 (3) ◽  
pp. 27-32
Author(s):  
N.V. Altunina
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Ldl Cholesterol ◽  
Density Lipoprotein ◽  
Hdl Cholesterol ◽  
Main Group ◽  
Apo B ◽  
Patients With Diabetes ◽  
History Of

Relevance. In diabetes mellitus (DM), atherosclerotic plaques contain more fat, are more inflammatory, and show a higher risk of thrombus formation than in individuals without diabetes. One of the significant factors in the development and progression of atherosclerosis in these patients is atherogenic dyslipidemia, which includes a wide range of disorders and often precedes the onset of diabetes for several years. Therefore, it is relevant to study the features of dyslipidemia in patients with diabetes after myocardial infarction (MI). Objective: to study changes in blood lipid spectrum parameters, including Apolipoproteins (Apo A-1, Apo B) and lipoprotein (a), in postinfarction patients with type 2 DM. Materials and methods. 119 patients (77 men and 42 women; mean age 61.09 ± 0.92 years) were examined, of which 42 were patients with coronary heart disease (CHD) who suffered from MI and type 2 diabetes (main group), 39 patients with a history of MI without concomitant diabetes (comparison group I) and 38 patients with type 2 diabetes without MI (comparison group II). The control group consisted of 30 healthy individuals, comparable in age and sex. Total cholesterol (TC), triglycerides (TG), and high-density lipoprotein cholesterol (HDLC) were determined in venous serum by enzymatic colorimetric method. According to the formulas, the level of cholesterol in very-low-density lipoproteins (VLDLC) was calculated; cholesterol in low-density lipoprotein (LDLC), coefficient of atherogenicity (CA). The level of lipoprotein (a) – LP (a), Apo A-1, and Apo B were determined by immunoturbidimetry. Blood sampling in patients was performed on an empty stomach. Results. In the main group, significantly higher rates of TC, TG, LDLC, VLDLC, AF, Apo B, and the ratio of Apo B/Apo A-1, compared with non-diabetic postinfarction patients. At the same time, there was a significantly lower concentration of HDLC, Apo A-1, and LP (a) – in patients with a history of diabetes mellitus. When comparing the indicators of patients in the main group with patients with isolated type 2 diabetes, there were significantly higher levels of LDL cholesterol and CA, as well as significantly lower concentrations of HDL cholesterol and apo A-1 in patients of the main group. The analysis of lipid metabolism in the comparison groups revealed a difference in the level of TG, LDL cholesterol, and Apo B, which have higher levels in patients with isolated type 2 diabetes, and the level of LP (a) – significantly higher in postinfarction patients, in contrast to diabetics. The results indicate deeper disorders of lipid metabolism in post-infarction patients with diabetes than in non-diabetic post-infarction patients, which may be due to insulin resistance, hyperinsulinemia, and hyperglycemia. Conclusions. Dyslipoproteinemia in postinfarction patients with type 2 diabetes is characterized by a decrease in the content of antiatherogenic HDL cholesterol and its protein Apo A-1, moderate hypertriglyceridemia, increased levels of LDL cholesterol, VLDL cholesterol, and Apo B, which causes higher values of cholesterol and increases AF. Elevations in lipid profile parameters such as TG, LDL cholesterol, and Apo B are more associated with diabetes, while higher concentrations of LP (a) are characteristic of postinfarction non-diabetic patients.

scholarly journals The Prevalence and Risk Factors of Diabetic Maculopathy in Type 2 Diabetes Mellitus: A Study From Central Nepal

2018 ◽  
Vol 4 (1) ◽  
pp. 16-21
Author(s):  
Nilam Munakarmi ◽  
Amrit Pokharel ◽  
Om Krishna Malla ◽  
Chhabindra Lal Pradhananga
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Ldl Cholesterol ◽  
Significant Risk ◽  
Diabetic Maculopathy ◽  
Cholesterol Levels

INTRODUCTION: Diabetic maculopathy is a complication of type 2 diabetes mellitus. This study was done to assess the prevalence and risk factors of Diabetic maculopathy in type 2 diabetes mellitus in Nepalese patients presenting to our hospital. MATERIAL AND METHODS: A hospital-based, descriptive, cross-sectional study was conducted at the department of ophthalmology, Kathmandu Medical College Teaching Hospital (KMCTH), Sinamangal, Kathmandu, Nepal from August, 2012 to October, 2014. 200 patients with type 2 diabetes mellitus underwent a detailed interview and a comprehensive dilated ocular evaluation by an ophthalmologist. Diabetic maculopathy was defined according to the international classification and grading system.  RESULTS: 200 patients suffering from type 2 diabetes mellitus included 90 men (45%) and 110 women (55%) of age ranging from 23 80 years (mean age = 56.23, median age = 57.5 and SD = 10.83). Diabetic maculopathy was detected in 22 patients (11%). The disease duration of 6 to 15 years had the highest prevalence of Diabetic maculopathy. Significant risk factors for diabetic maculopathy were higher levels of HbA1c (p = 0.005), higher values of blood pressure (p = 0.001), higher cholesterol levels (p = 0.000), higher LDL-cholesterol levels (p = 0.000), higher triglyceride levels (p = 0.000), higher creatinine values (p = 0.000), higher urea values (p = 0.000), higher FBS levels (p = 0.020), higher PPBS levels (p = 0.001) and lower hemoglobin values (p = 0.000). CONCLUSION: Significant risk factors for diabetic maculopathy were higher levels of HbA1c, higher values of blood pressure, higher cholesterol levels, higher LDL-cholesterol levels, higher triglyceride levels, higher creatinine values, higher urea values, higher FBS levels, higher PPBS levels and lower hemoglobin values. However, smoking, drinking alcohol, dietary habits, HDL and BMI contributed as insignificant risk factors.Journal of Universal College of Medical Sciences (2016) Vol.04 No.01 Issue 13, Page: 16-21

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