Bridging the Gap between Evidence and Practice: Nationwide Retrospective Analysis of Lipid-Modifying Therapy Prescription Patterns in 5 Million Patients with Type 2 Diabetes Mellitus

Introduction: Type 2 diabetes mellitus (T2DM) is associated with dyslipidemia and significantly increased cardiovascular risk, making lipid-modifying therapy a crucial preventive intervention in these patients. Despite clear guidelines recommending statin therapy for both primary and secondary prevention, real-world prescription routines and practices show gaps in clinical care. We aimed to evaluate the rates and patterns of lipid-modifying therapy under prescription among T2DM patients across U.S. healthcare facilities. Methods: We conducted a retrospective observational analysis using the TriNetX US Collaborative Network database, including data from 69 healthcare organizations throughout the United States. Patients with T2DM patients aged 40-75 years were included in our cohort. Under-prescription rates were calculated and analyzed across demographic subgroups using standardized protocols within the TriNetX platform. Results: Among 5,007,910 T2DM patients, we observed significant statin under-prescription rates. Our analysis showed a prescription rate of 55.1% for statins in eligible patients with T2DM. Conclusions: Our findings revealed a significant under-prescription of lipid-modifying therapy in T2DM patients. The universal nature of under-prescription suggests barriers to guideline implementation. These results underscore the urgent need for systematic interventions, including automated identification systems, standardized protocols, and optimized provider education to improve cardiovascular risk management in patients with T2DM.