Poor lipid control in type-2 diabetics with and without ischemic heart disease

To determine the frequency of type-2 diabetics who have target lipoprotein blood levels, to study these levels in patients with ischemic heart disease and cardiovascular disease risk factors, and to study the possible causes of poor control, we reviewed hyperlipdemic type-2 diabetics who were on regular follow up to the medical outpatient clinic of King Abdulaziz University Hospital from January 2000 to January 2001. A total of 202 patients were studied with mean age of 60 yr and equal male to female ratio. The mean duration of diabetes was 10 yr and it was 7 yr for hyperlipidemia. The mean level of LDL was 3.15 mmol/L and it was 1.0 mmol/L and 2.47 mmol/L for HDL and TG, respectively. Only 31 % of patients had LDL < 2.6 mmol/L, 28% had HDL > 1.1 mmol/L, and 37% had TG < 1.7 mmol/L. No significant difference was found in the frequency of target level of LDL in patients with IHD and those without; 26% vs 34% (0.4). Similarly, no difference was found in those with hypertension, obesity, and patients with family history of IHD compared to those without these risk factors; 30%, 26%,16% vs 34%,36%, 33% (p = 0.2, 0.1, 0.4, respectively). Males were found to have a higher frequency of target LDL level compared to females; 38% vs 25% (p = 0.04). Poor diet restriction was found in 90% of patients' with poor control, lack of patients' knowledge in 62%, 70% have financial reasons, 86% of patients on multiple medications, and in 16% the treating physician took no proper action. In conclusion, a low frequency of type-2 diabetics have target levels of lipoproteins. Diabetics with IHD and CVD risk factors also have poor lipid control. Poor control was associated with poor diet compliance and use of multiple medications. Proper management and control of this disease is needed among elderly patients.