By itself, diabetes already poses a series of health-related risks and complications1. But coupled with unhealthy levels of cholesterol, patients with diabetes significantly become even more prone to suffer from cardiovascular diseases (CVDs)2. These disorders that affect the heart and blood vessels, and are commonly characterized by the build-up of fatty deposits in the arteries (atherosclerosis) that can lead to stroke and heart attack2, account for 50% of deaths among persons with diabetes3.
In the Philippines alone, diabetes is recorded as the fourth leading cause of death based on a 2020 census of the Philippine Statistics Authority4. Given the rising prevalence of diabetes across all adult age groups and sex5 and with the imposing risk of cardiovascular death, the healthcare community is encouraging patients with diabetes to prioritize cholesterol management6,7 – a message being similarly echoed by global healthcare company, Viatris.
With its BE THERE campaign, Viatris are encouraging patients with diabetes to manage their cholesterol levels to reduce the risk of untimely death so they can “be there” to enjoy their family’s important milestones. “At Viatris, we empower people to live healthier at every stage of life. We want to raise awareness on the complications of diabetes and help patients avoid the life-threatening risks associated with it—that they can and should be able to enjoy their lives to the fullest despite their illness,” says Viatris Philippines Medical Lead Dr. Jermaine Lim.
Through the campaign, partnering healthcare professionals can educate on proper cardiovascular risk reduction by guiding patients on how to properly manage their cholesterol levels on top of their overall diabetes care8. The campaign emphasizes heeding a doctor’s recommendation for lifestyle changes such as exercising, integrating a more heart-healthy diet, and most importantly, having the proper medication to lower cholesterol9.
“Cholesterol medication can greatly reduce the risk of heart attacks and stroke, making them an important part of diabetes care6,9,” says Dr. Bien Matawaran, past president of the Philippine Society of Endocrinology, Diabetes and Metabolism and current chief of the Section of Endocrinology, Diabetes and Metabolism of the UST Hospital. “In fact, studies have shown that having the proper lifestyle changes and medical treatment can greatly reduce cardiovascular events among patients with Type 2 diabetes mellitus by more than 50%10.”
Furthermore, “it should be made known that people with diabetes are never at low risk for cardiovascular disease11, thus it is recommended to lower bad cholesterol by 50%, especially in those who have been diagnosed for at least 10 years, regardless of current or baseline levels11,” stresses Dr. Matawaran. “We must encourage patients to consult their doctors and have that thorough discussion regarding their case of diabetes. By doing so, patients with diabetes are prescribed anti-cholesterol medication that can provide the desired bad cholesterol reduction and are given the timely support and care that they need.”
According to Dr. Matawaran, some patients may be given a single medication while some may need a combination of cholesterol medications12. “One form of medication are statins. Statins work by blocking a substance in the liver needed to make cholesterol thereby lowering bad cholesterol, increasing good cholesterol and lowering blood fats or triglycerides9,12,” he explained. Patients with persistently high triglyceride levels may also be prescribed with fibrates13 or omega-3 fatty acids (fish oils)14 along with the statin. Before taking any medication, it is important for diabetic patients to consult with their doctor the appropriate treatment for their condition9.
Dr. Matawaran further emphasizes that once medication has been given alongside the lifestyle interventions, it is imperative that patients strictly adhere to the advised diet and exercise plans as well as taking medications as prescribed. “Medication adherence is associated with improved outcomes, such as achieving good diabetes control, and even preventing mortality and morbidity15,” he adds. To help practice medication adherence, he recommends patients to take their medication at the same time everyday and keep a “medicine calendar”16.
Dr. Lim reminds patients with diabetes: “It has never been timelier to have a conversation with your doctor about cholesterol management. So don’t hesitate to seek medical help so that you can continue to BE THERE with your family for the sweeter things in life.”
1American Diabetes Association. Diabetes Overview. Complications. Available at: https://www.diabetes.org/diabetes/complications. Accessed on January 3, 2022.
2American Heart Association. Cholesterol and Diabetes. Available at: https://www.heart.org/en/health-topics/diabetes/diabetes-complications-and-risks/cholesterol-abnormalities–diabetes. Accessed on December 27, 2021.
3 Einarson, T. R. et al. Prevalence of cardiovascular disease in type 2 diabetes: a systematic literature review of scientific evidence from across the world in 2007-2017. Cardiovascular diabetology, 17(1), 83. Available at: https://doi.org/10.1186/s12933-018-0728-6. Accessed on January 5, 2022.
4 Philippine Statistics Authority. Causes of Deaths in the Philippines (Preliminary): January to December 2020. Available at: https://psa.gov.ph/content/causes-deaths-philippines-preliminary-january-december-2020-0. Accessed on December 27, 2021.
5 Food and Nutrition Research Institute. Health and Nutritional Status of Filipino Adults, 20-59 years old (2018). Available at http://enutrition.fnri.dost.gov.ph/site/uploads/Adults_and_Elderly.pdf. Accessed on 27 December 2021.
6 Gupta, M et al. Management of cholesterol in diabetes-a review. Cardiology 2010;7(2):20–4 Available at: https://doi.org/10.15420/usc.2010.7.2.20, Accessed on January 3, 2022.
7 Remedy Health Media &. High Cholesterol Risk Factors. Should You Be Concerned? Available at: https://www.endocrineweb.com/guides/high-cholesterol-diabetes/high-cholesterol-risk-factors. Accessed on January 3, 2022.
8 WebMD. Tips for Heart-Healthy Living With Diabetes. Available at: https://www.webmd.com/diabetes/diabetes-heart-health#:~:text=Aim%20for%20these%20scores%3A,and%20above%2040%20for%20men. Accessed on January 3, 2022.
9 Remedy Health Media &. High Cholesterol Treatments. Treatment Options When You Have High Cholesterol and Type 2 Diabetes. Available at: https://www.endocrineweb.com/guides/high-cholesterol-diabetes/high-cholesterol-treatments. Accessed on January 3, 2022.
10 Newman, J. et al. Primary Prevention of Cardiovascular Disease in Diabetes Mellitus. Journal of the American College of Cardiology. 2017;70(7)883-893. Available at: https://doi.org/10.1016/j.jacc.2017.07.001. Accessed on January 3, 2021.
11 Mach, F., et al., ESC Scientific Document Group, 2019 ESC/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk: The Task Force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and European Atherosclerosis Society (EAS), European Heart Journal. 2020:41(1):111-188. Available at: https://doi.org/10.1093/eurheartj/ehz455. Accessed on January 3, 2022.
12Mayo Clinic. Cholesterol medications: consider the options. Available at: https://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/in-depth/cholesterol-medications/art-20050958. Accessed on January 4, 2022.
13 Fiévet, C and Staels, B. Combination therapy of statins and fibrates in the management of cardiovascular risk. Current Opinion in Lipidology. 2009;20(6):505-511. Available at: https://dx.doi.org/10.1097%2FMOL.0b013e328332e9ef. Accessed on January 12, 2022.
14 Nambi, V and Ballantyne, CM. Combination therapy with statins and omega-3 fatty acids. The American Journal of Cardiology 2006;98(4):34-38. Available at: https://doi: 10.1016/j.amjcard.2005.12.025. Accessed on January 12, 2022.
15 Aloudah, N. M et al. Medication adherence among patients with Type 2 diabetes: A mixed methods study. PloS one. 2018;13(12): e0207583. Available at: https://10.1371/journal.pone.0207583. Accessed on January 3, 2022.
16 Why You Need to Take Your Medications as Prescribed or Instructed. US Food and Drug Administration website. Available at http://www.fda.gov/Drugs/ResourcesForYou/SpecialFeatures/ucm485545.htm. Accessed on January 25, 2022