Statin treatment in type 2 diabetes patients

Type 2 diabetes patients have a higher risk of developing cardiovascular and cerebrovascular diseases, therefore statins are recommended for almost all diabetes patients. Although it has been shown that statins can have substantial health and economic benefits, treatment in clinical practice is often suboptimal. This is due to low-dosing, lack of intensification of treatment and non-adherence to treatment. Patients on a low dose are less likely to achieve treatment targets, which could be because they are more sensitive to non-response due to non-adherence. Non-adherence and discontinuation rates are high in clinical practice and associated with patients’ preferences. In our study patients where however willing to continue lipid-lowering treatment, which might be because we gave specific information regarding benefits and drawbacks of stopping and continuing treatment. The willingness to continue and the importance patients attached to specific treatment characteristics (e.g. risk reductions in cardiovascular events and risk for adverse events) were dependent on characteristics like age, clinical history and education. Therefore interventions aimed at improving adherence should take patient characteristics into account. As treatment is suboptimal due to both patient related factors (non-adherence and patients’ preferences), and physician related factors (treatment dosing and treatment modifications), interventions to optimize statin treatment should be multifaceted combinations that target both the patient and the physician.