Management of dyslipidaemia in patients with type 2 diabetes in Australian primary care
Thomas, M.C.; Nestel, P.J.
Medical Journal of Australia 186(3): 128-130
2007
ISSN/ISBN: 0025-729X PMID: 17309401 Document Number: 609996
Objective: To examine the frequency of dyslipidaemia and treatment with lipid-lowering drugs in patients with type 2 diabetes managed in Australian primary care. Design, setting and participants: The NEFRON study (National Evaluation of the Frequency of Renal Impairment cO-existing with NIDDM [Non-Insulin Dependent Diabetes Mellitus]) was an incident-driven, cluster-stratified survey of 3893 patients with type 2 diabetes from across Australian primary care between April and September 2005. Main outcome measures: The most recent fasting lipid levels were compared with therapeutic targets for lipid control and current prescribing guidelines. Results: 64% of patients with type 2 diabetes presenting in primary care received lipid-lowering medication. Despite the widespread use of statins (61%), 75% of patients had a total cholesterol level >=4.0 mmol/L, and 47% had a low-density lipoprotein (LDL) cholesterol level >=2.5 mmol/L. Few untreated patients met the Australian Pharmaceutical Benefits Scheme (PBS) criteria current at the time for subsidised primary prevention with lipid-lowering agents (4%). However, new PBS subsidy criteria will potentially include 93% of all diabetic patients seeing their general practitioner in primary care. Conclusion: Changes in the provision of subsidised therapy for high-risk diabetic patients are long overdue. However, more needs to be done to optimise management strategies, which still fail to achieve treatment targets in many treated patients.