Lack of improvement in the treatment of hyperlipidemia among patients with type 2 diabetes

Am J Med. 2003 Apr 1;114(5):377-82. doi: 10.1016/s0002-9343(02)01566-8.


Purpose: We investigated the adequacy of treatment of hyperlipidemia in patients with type 2 diabetes, and assessed the temporal trends in adherence to published guidelines.

Methods: We performed a post hoc analysis of 501 patients enrolled in the Appropriate Blood Pressure Control in Diabetes trial. All patients had fasting lipid profiles at baseline and during the 5 years (1993 to 1998) of the trial. Achieving the National Cholesterol Education Panel's goals for hyperlipidemia management was the primary outcome.

Results: The percentage of patients with a low-density lipoprotein (LDL) cholesterol level less than 130 mg/dL was 53% (n = 266) at baseline and 54% (n = 270) at the end of 5 years (P = 0.75). Almost 14% (n = 69) of these patients continued to have an LDL cholesterol level greater than 160 mg/dL at the completion of the study. Only 19% (n = 25) of the 133 patients with known coronary artery disease had an LDL cholesterol level less than 100 mg/dL at baseline, and only 16% (n = 21) achieved this level at the completion of the study (P = 0.37).

Conclusion: Although prevention of cardiovascular disease in patients with diabetes is a public health priority, our results suggest that hyperlipidemia is being treated suboptimally.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Cholesterol, LDL / blood
  • Coronary Artery Disease / etiology
  • Diabetes Mellitus, Type 2 / complications*
  • Female
  • Guideline Adherence*
  • Humans
  • Hyperlipidemias / blood
  • Hyperlipidemias / complications
  • Hyperlipidemias / drug therapy*
  • Hypolipidemic Agents / therapeutic use
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Practice Guidelines as Topic*


  • Cholesterol, LDL
  • Hypolipidemic Agents