Disparities in lipid control and statin drug use among diabetics with noncoronary atherosclerotic vascular disease vs those with coronary artery disease

•We assessed current day lipid control in diabetes mellitus (DM) with atherosclerotic vascular disease.•We compared lipid control in DM with coronary artery disease vs DM with noncoronary atherosclerotic vascular disease (NCVD) groups.•Statin drugs were significantly underutilized in the DM with NCVD group.•Less aggressive doses of statin drugs were used in the DM with NCVD group.•As a result, mean low-density lipoprotein and total cholesterol were higher in the NCVD group.

BackgroundDiabetes mellitus (DM), coronary artery disease (CAD), and noncoronary atherosclerotic vascular diseases (NCVDs) have similar risks of cardiovascular events and similar recommendations for lipid control. There are limited data regarding lipid control in diabetic patients with NCVD in current clinical practice.ObjectiveTo assess current day practice of lipid control in patients with DM with NCVD vs those with CAD.MethodsWe retrospectively identified 3336 patients with DM and known atherosclerotic vascular disease between January 2009 and March 2012. We compared demographic variables, lipid levels, and statin use in diabetics with CAD alone vs diabetics without CAD but with one or more NCVD.ResultsThere were 234 patients in DM with NCVD group and 3102 patients in DM with CAD group. The DM with NCVD group had a higher mean total cholesterol (152 ± 40 vs 146 ± 42 mg/dL; P = .019) and mean low-density lipoprotein (LDL; 86 ± 35 vs 80 ± 34 mg/dL; P = .04) with only 70% of patients achieving LDL of <100 mg/dL (compared with 80% in the DM with CAD group; P < .001). Statin use was 100% in CAD vs 75% in NCVD group (P < .001). In addition to limited use of more potent statins in the NCVD group, there was also a significantly lower dose of statins used overall.ConclusionOur study demonstrates lower use and less aggressive application of statins among diabetics with NCVD compared with diabetics with CAD, resulting in higher mean LDL and total cholesterol in the NCVD group.