Suboptimal LDL-cholesterol control under the 2019 ESC/EAS dyslipidemia guidelines: Results from the nationwide TEMD-2 study in type 2 diabetes

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dc.authorid0000-0001-7566-5427
dc.authorid0000-0002-6866-2364
dc.authorid0000-0002-8286-5256
dc.authorid0000-0001-5133-1318
dc.authorid0000-0001-7490-2937
dc.authorid0000-0001-9259-7024
dc.authorid0000-0003-4867-3725
dc.authorid0000-0003-4510-6282
dc.authorid0000-0001-8613-1797
dc.authorid0000-0002-9637-6744
dc.authorid0000-0002-9309-7715
dc.contributor.authorTelci Çaklılı, Özge
dc.contributor.authorHaymana, Cem
dc.contributor.authorDemirci, İbrahim
dc.contributor.authorKebapçı, Medine Nur
dc.contributor.authorSarıakçalı, Barış
dc.contributor.authorEvren, Bahri
dc.contributor.authorDizdar, Oğuzhan Sıtkı
dc.contributor.authorSalman, Serpil
dc.contributor.authorErsoy, Canan
dc.contributor.authorSatman, İlhan
dc.contributor.authorBayram, Fahri
dc.contributor.authorSönmez, Alper
dc.date.accessioned2026-05-11T13:49:58Z
dc.date.available2026-05-11T13:49:58Z
dc.date.issued2026
dc.departmentFakülteler, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, İç Hastalıkları Ana Bilim Dalı
dc.description.abstractBackground: Lowering LDL cholesterol (LDL-C) decreases cardiovascular risk substantially in type 2 diabetes. Despite stricter LDL-cholesterol targets in the 2019 ESC/EAS dyslipidemia guidelines, target achievement in clinical practice remains insuffi cient. TEMD-2 is designed to evaluate LDL-cholesterol target attainment in Turkish patients with type 2 diabetes in the context of the updated 2019 ESC/EAS guidelines. Methods: This multicenter cross-sectional study included adults with type 2 diabetes followed in 70 tertiary endocrine clinics across 36 cities between October 2022 and January 2023. Sociodemographic characteristics, comorbidities, lifestyle factors, com plications, laboratory measurements, and lipid-lowering therapies were assessed using standardized questionnaires and clinical evaluations. LDL-C target was assigned according to cardiovascular risk categories. Independent predictors of goal attainment were identified using multivariable logistic regression. Results: Among 4956 adults with type 2 diabetes, 99.5% required statin therapy, whereas 37.1% were on treatment. Overall, 8.3% of the cohort achieved LDL-cholesterol targets, with attainment lowest in those at very high risk (5.8%). Target achievement among statin users was 57.7% in moderate-risk, 18.1% in high-risk, and 9.4% in very-high-risk patients. Individuals on target had lower body mass index, haemoglobin A1c (HbA1c), triglycerides, and a lower prevalence of microvascular complications. Statin therapy was the strongest positive predictor of success (odds ratio 2.39), while smoking, presence of neuropathy, nephropathy, female sex, older age, and higher HbA1c were associated with lower likelihood of achieving LDL-cholesterol goals. Therapeutic inertia was present in 87.2% of patients, defined as no intensification of lipid-lowering therapy despite LDL-cholesterol levels above target.
dc.identifier.citationTelci Çaklılı, Ö., Haymana, C., Demirci, İ., Kebapçı, M. N., Sarıakçalı, B., Evren, B., Dizdar, O. S., Salman, S., Ersoy, C., Satman, İ., Bayram, F., & Sönmez, A. (2026). Suboptimal LDL-cholesterol control under the 2019 ESC/EAS dyslipidemia guidelines: Results from the nationwide TEMD-2 study in type 2 diabetes. Diabetes, Obesity and Metabolism, pp. 1-12. https://doi.org/10.1111/dom.70806
dc.identifier.doi10.1111/dom.70806
dc.identifier.endpage12
dc.identifier.issn1463-1326
dc.identifier.issn1462-8902
dc.identifier.pmidPMID: 42092235
dc.identifier.scopusqualityQ1
dc.identifier.startpage1
dc.identifier.urihttps://doi.org/10.1111/dom.70806
dc.identifier.urihttps://hdl.handle.net/20.500.13055/1475
dc.identifier.wosWOS:001757635300001
dc.identifier.wosqualityQ1
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.indekslendigikaynak.otherSCI-E - Science Citation Index Expanded
dc.institutionauthorSalman, Serpil
dc.institutionauthorid0000-0003-4867-3725
dc.language.isoen
dc.publisherWiley
dc.relation.ispartofDiabetes, Obesity and Metabolism
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/closedAccess
dc.subjectDiabetes Complications
dc.subjectDyslipidaemia
dc.subjectLipid-Lowering Therapy
dc.subjectMacrovascular Disease
dc.titleSuboptimal LDL-cholesterol control under the 2019 ESC/EAS dyslipidemia guidelines: Results from the nationwide TEMD-2 study in type 2 diabetes
dc.typeArticle
dspace.entity.typePublication

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