Use of non‐LDL‐C lipid‐lowering medications in patients with type 2 diabetes

Abstract

Abstract Background A number of non‐low‐density lipoprotein cholesterol lipid abnormalities are associated with type 2 diabetes and insulin resistance, which may lead practitioners to use medications targeting these abnormal lipid fractions despite a lack of evidence or guideline recommendations. Methods and Results Among 382 921 US patients with type 2 diabetes (69% with cardiovascular disease, 76% on a statin), 95 995 (26%) were on some nonstatin lipid‐lowering medication—19 265 (5%) on niacin, 32 919 (9%) on a fibrate and 69 513 (18%) on fish oil. Use of all three medications was stable over time and higher in patients with cardiovascular disease and with higher triglyceride levels, although even among patients with triglyceride levels <2.3 mmol/L, 6% were on a fibrate and 17% were on fish oil. Conclusion As clinical trials demonstrate little to no cardiovascular benefit from taking these medications, greater attention is needed to focus the use of lipid‐lowering medications to those with proven benefit.

Keywords

• diabetes mellitus
• lipids
• quality of care
• triglycerides