Adults with type 2 diabetes mellitus (T2DM) continued to show poor low-density lipoprotein cholesterol (LDL-C) target attainment despite updated lipid management recommendations, according to findings from the cross-sectional TEMD-2 study published in Diabetes, Obesity and Metabolism.

The analysis included 4,956 adults treated across 70 tertiary endocrine clinics in 36 cities between October 2022 and January 2023. LDL-C target achievement was evaluated according to the 2019 European Society of Cardiology (ESC)/European Atherosclerosis Society (EAS) dyslipidemia guidelines.

Statin therapy was indicated in 99.5% of the cohort, but only 37.1% were receiving treatment. Overall, LDL-C target attainment was reported in 8.3% of patients. Attainment was lowest among those at very high cardiovascular risk (5.8%).

Among statin users, LDL-C goal achievement reached 57.7% in moderate-risk patients, 18.1% in high-risk patients, and 9.4% in very-high-risk patients. Patients who achieved LDL-C targets had lower body mass index, hemoglobin A1c (HbA1c), and triglyceride levels. They also had a lower prevalence of microvascular complications.

Statin therapy was the strongest positive predictor of LDL-C target attainment (odds ratio [OR] 2.39). Smoking, female sex, older age, higher HbA1c levels, neuropathy, and nephropathy were associated with a lower likelihood of reaching LDL-C goals. Therapeutic inertia affected 87.2% of patients with LDL-C levels above target.

Three years after implementation of the updated ESC/EAS dyslipidemia guidelines, LDL-C target attainment remained low among adults with T2DM, particularly in those at very high cardiovascular risk.