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Evaluation of statin prescriptions in type 2 diabetes: India Heart Watch-2
  1. Rajeev Gupta1,
  2. Sailesh Lodha1,
  3. Krishna K Sharma2,
  4. Surendra K Sharma3,
  5. Sunil Gupta4,
  6. Arthur J Asirvatham5,
  7. Bhupendra N Mahanta6,
  8. Anuj Maheshwari7,
  9. Dinesh C Sharma8,
  10. Anand S Meenawat9,
  11. Raghubir S Khedar1
  1. 1Departments of Preventive Cardiology, Internal Medicine and Endocrinology, Eternal Heart Care Centre and Research Institute, Mount Sinai New York Affiliate, Jaipur, Rajasthan, India
  2. 2Research Unit, Fortis Escorts Hospital, Jaipur, Rajasthan, India
  3. 3Department of Endocrinology, Galaxy Specialty Centre, Jaipur, Rajasthan, India
  4. 4Department of Diabetes, Diabetes Care and Research Centre, Nagpur, Maharashtra, India
  5. 5Department of Diabetes, Madurai Medical College, Madurai, Tamil Nadu, India
  6. 6Department of Medicine, Assam Medical College, Dibrugarh, Assam, India
  7. 7Department of Medicine, BBD College of Dental Sciences, Lucknow, Uttar Pradesh, India
  8. 8Department of Endocrinology, RNT Medical College, Udaipur, Rajasthan, India
  9. 9Department of Medicine, Satyam Hospital, Jodhpur, Rajasthan, India
  1. Correspondence to Dr Rajeev Gupta; rajeevgg{at}gmail.com

Abstract

Background Contemporary treatment guidelines advise statin use in all patients with diabetes for reducing coronary risk. Use of statins in patients with type 2 diabetes has not been reported from India.

Methods We performed a multisite (n=9) registry-based study among internists (n=3), diabetologists (n=3), and endocrinologists (n=3) across India to determine prescriptions of statins in patients with type 2 diabetes. Demographic and clinical details were obtained and prescriptions were audited for various medications with a focus on statins. Details of type of statin and dosage form (low, moderate, and high) were obtained. Patients were divided into categories based on presence of cardiovascular risk into low (no risk factors, n=1506), medium (≥1 risk factor, n=5425), and high (with vascular disease, n=1769). Descriptive statistics are presented.

Results Prescription details were available in 8699 (men 5292, women 3407). Statins were prescribed in 55.2% and fibrates in 9.2%. Statin prescription was significantly greater among diabetologists (64.4%) compared with internists (n=53.3%) and endocrinologists (46.8%; p<0.001). Atorvastatin was prescribed in 74.1%, rosuvastatin in 29.2%, and others in 3.0%. Statin prescriptions were lower in women (52.1%) versus men (57.2%; p<0.001) and in patients aged <40 years (34.3%), versus those aged 40–49 (49.7%), 50–59 (60.1%), and ≥60 years (62.2%; p<0.001). Low-dose statins were prescribed in 1.9%, moderate dose in 85.4%, and high dose in 12.7%. Statin prescriptions were greater in the high-risk group (58.0%) compared with those in the medium-risk (53.8%) and low-risk (56.8%) groups (p <0.001). High-dose statin prescriptions were similar in the high-risk (14.5%), medium-risk (11.8%), and low-risk (13.5%) groups (p=0.31).

Conclusions Statins are prescribed in only half of the clinic-based patients in India with type 2 diabetes. Prescription of high-dose statins is very low.

  • Asian Indians
  • Lipid-Lowering Drugs/Medication
  • Atorvastatin
  • Health Service Delivery

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