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Vol. 34. Issue 1.
Pages 19-26 (January - February 2022)
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Vol. 34. Issue 1.
Pages 19-26 (January - February 2022)
Original article
Application of the individualized objectives defined by the European 2019 lipid guidelines in patients with type 2 diabetes
Aplicación de los objetivos individualizados definidos por la guía europea 2019 de lípidos en pacientes con diabetes tipo 2
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David Martín Enguixa,
Corresponding author
davidm123m45@hotmail.com

Corresponding author.
, Abraham Hidalgo Rodríguezb, María Sánchez Cambroneroc, Juan Carlos Aguirre Rodríguezc
a Centro de Salud La Zubia, Distrito Sanitario Granada Metropolitano, La Zubia, Granada, Spain
b Centro de Salud Realejo, Distrito Sanitario Granada Metropolitano, Granada, Spain
c Centro de Salud Fortuny Velutti, Distrito Sanitario Granada Metropolitano, Granada, Spain
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Table 1. Classification of the cardiovascular risk of the patients of the study and their consequent LDL cholesterol objective.
Table 2. Variables relating to lipid control.
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Abstract
Background and objective

cardiovascular disease is one of the main complications of people with type 2 diabetes (T2D). The ESC/ESA 2019 lipid guide has led to a change in dyslipidemia control. We analyse the evolution of the lipid profile, the fulfillment of the LDL-C targets, how patients are classified and the impact of this guide on lipid control in T2D patients.

Materials and methods

A prospective cohort study from 2017 to 2020 from a cohort of 297 T2D out of a total of 1229 (95% confidence level). We classified patients according to their cardiovascular risk (CVR) and whether they met or their low-density cholesterol (LDL-C) goal.

Results

Age: 62.58 ± 10.68; 52.79% men. Mean LDL-C levels 116.2 at baseline and 100.2 mg/dl at four years (p < .001). They met their individualized LDL-C target after publication of the guide: 57 (21.67%). There were more controls who were under 65 (57.9% vs 36.9% p < .01; RR 0.83), men (66.7% vs 49.5% p < .05; RR 0, 86) and smokers (17.5% vs 7.8% p < .05). 74.23% had a high CVR and a target LDL-C <70 mg/dl.

Conclusions

Since the publication of the ESC/ESA 2019 lipid guide, a decrease in LDL-c levels has been observed. Only one in five patients fulfill their individualized LDL-C target. Male patients, under 65 years of age and smokers presented an advantage in meeting their goal. Most T2D patients have a high CVR, and the predominant LDL-C target is less than 70 mg/dl.

Keywords:
Type 2 diabetes mellitus
Cardiovascular risk
Dyslipidemia
Resumen
Antecedentes y objetivo

La enfermedad cardiovascular supone una de las principales complicaciones de las personas con diabetes tipo 2 (DM2). La guia ESC/ESA 2019 de lípidos ha supuesto un cambio en control de dislipemia. Analizamos la evolución del perfil lipídico, el cumplimiento de los objetivos de c-LDL, como clasifica a los pacientes y el impacto de esta guía en el control lipídico en pacientes con DM2.

Materiales y métodos

Estudio de cohortes prospectivo de 2017 a 2020 de una cohorte de 297 DM2 de un total de 1229(nivel confianza 95%).Clasificamos a los pacientes en función de su riesgo cardiovascular (RCV) y si cumplía o su objetivo de colesterol de baja densidad (c-LDL).

Resultados

Edad: 62,58 ± 10,68; 52,79% hombres. Niveles de c-LDL medio 116,2 al inicio y 100,2 mg/dL a los cuatro años años (p < 0,001). Cumplían su objetivo individualizado de c-LDL después de la publicación de la guía: 57 (21,67%). Hubo más controlados que eran menores de 65 (57,9% vs 36,9% p < 0,01; RR 0,83), varones (66,7% vs 49,5%;p < 0,05; RR 0,86) y fumadores (17,5%vs7,8%;p < 0,05). El 74,23% tenía un RCV alto y un objetivo c-LDL <70 mg/dl.

Conclusiones

Desde la publicación de la guía de lípidos ESC/ESA 2019 se observa un descenso en los niveles de c-LDL. Aun así, solo uno de cada cinco pacientes cumple su objetivo individualizado de c-LDL. Presentaron una ventaja de cumplir su objetivo los pacientes con sexo varón, menores de 65 años y fumadores. La mayoría de los pacientes DM2 tienen un RCV alto y el objetivo de c-LDL predominante es inferior a 70 mg/dl.

Palabras clave:
Diabetes mellitus tipo 2
Riesgo cardiovascular
Dislipemia

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