Lack of Goal Attainment Regarding the Low-density Lipoprotein Cholesterol Level in the Management of Type 2 Diabetes Mellitus
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概要
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Objective The management of diabetes mellitus includes controlling the blood glucose level, body weight, blood pressure and serum lipid level. The coexistence of diabetes and a high low-density lipoprotein cholesterol (LDL-C) level promotes atherosclerosis of the coronary arteries and increases the risk of coronary artery disease (CAD). We compared the rates of attainment of LDL-C goals in type 2 diabetes patients receiving primary and secondary prevention therapy, the former without a history of CAD and the latter with a history of CAD. Because patients receiving secondary prevention are at greater risk of coronary events, LDL-C management is especially important in this group. This study was designed to determine how frequently diabetic patients attain their LDL-C goals and identify the reasons for the lack of attainment. Methods The groups were distinguished according to the patients' medical records. Contributory factors for the patients not achieving their goals were recorded in a questionnaire filled out by each patient's physician. Results The overall attainment rate in both groups was 61%. The most frequent impediment in both groups was "an LDL-C level above or below the goal at every hospital visit" followed by "continuously sufficient effects of dietary therapy only" and the "management of LDL-C by other departments or hospitals," the latter reflecting the increasing problems of polydisease and polypharmacy in diabetes care. Conclusion Polydisease and polypharmacy issues in diabetes patients with a history of CAD constitute a growing barrier to medication adherence and the attainment of treatment goals.
- 社団法人 日本内科学会の論文
著者
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INAGAKI Nobuya
Department of Diabetes & Clinical Nutrition, Graduate School of Medicine, Kyoto University
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Fujita Yoshihito
Department Of Anesthesiology And Medical Crisis Management Nagoya City University Graduate School Of
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Harada Norio
Department Of Cardiology Nagoya University Graduate School Of Medicine
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Toyoda Kentaro
Department Of Metabolism And Clinical Nutrition Graduate School Of Medicine Kyoto University
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Hosokawa Masaya
Department Of Diabetes And Clinical Nutrition Kyoto University Graduate School Of Medicine
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Hamasaki Akihiro
Department Of Diabetes And Clinical Nutrition Kyoto University Faculty Of Medicine
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Nagashima Kazuaki
Department Of Diabetes And Clinical Nutrition Kyoto University Faculty Of Medicine
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Fujimoto Shimpei
Department Of Diabetes And Clinical Nutrition Graduate School Of Medicine Kyoto University
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Fujimoto Shimpei
Department of Diabetes, Endocrinology and Nutrition, Graduate School of Medicine, Kyoto University, Japan
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Harashima Shinichi
Department of Diabetes, Endocrinology and Nutrition, Graduate School of Medicine, Kyoto University, Japan
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Nakahigashi Yuko
Department of Diabetes, Endocrinology and Nutrition, Graduate School of Medicine, Kyoto University, Japan
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Hamasaki Akihiro
Department of Diabetes, Endocrinology and Nutrition, Graduate School of Medicine, Kyoto University, Japan
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Hosokawa Masaya
Department of Diabetes, Endocrinology and Nutrition, Graduate School of Medicine, Kyoto University, Japan
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Toyoda Kentaro
Department of Diabetes, Endocrinology and Nutrition, Graduate School of Medicine, Kyoto University, Japan
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