Prevalence, Predictors, and Treatment Gaps of Dyslipidemia in Patients with Type 2 Diabetes Mellitus: A Narrative Review
Article Sidebar
Dyslipidemia,
Predictors,
Treatment gaps Diabetes melitus tipe 2,
Dislipidemia,
Prediktor,
Kesenjangan pengobatan
Main Article Content
Abstract
The Indonesian pharmaceutical industry faces significant challenges related to dependence on imported raw materials, exchange rate volatility, production costs, and the need to strengthen research and development (R&D). These conditions highlight the importance of evaluating financial performance through distinct dimensions of efficiency and effectiveness. This study aims to analyze the production cost efficiency and asset utilization effectiveness of six pharmaceutical companies listed on the Indonesia Stock Exchange in fiscal year 2025 and to examine operational and financial factors associated with differences in their performance. A descriptive quantitative approach with a cross-sectional comparative design was employed using audited annual reports and financial statements for 2025. Financial ratios were analyzed alongside pharmaceutical industry management considerations, including production costs, asset utilization, productivity, R&D investment, human resource management, capital structure, and foreign exchange exposure. The findings indicate that Darya-Varia Laboratoria Tbk (DVLA) and Phapros Tbk (PEHA) recorded the highest gross profit margins, at 54.34% and 52.35%, respectively. Meanwhile, Merck Indonesia Tbk (MERK), Kalbe Farma Tbk (KLBF), and Tempo Scan Pacific Tbk (TSPC) achieved the highest returns on assets, at 19.17%, 12.20%, and 11.32%, respectively. However, the multidimensional assessment produced different overall rankings, demonstrating that strong production cost efficiency does not necessarily correspond to superior asset utilization effectiveness. Although PEHA achieved the second-highest gross profit margin, its overall performance was constrained by weaker results in other dimensions and a high debt-to-equity ratio of 224.51%. The study also identifies limitations in the comparability of nonfinancial disclosures concerning R&D, production capacity utilization, and foreign exchange exposure. In conclusion, pharmaceutical companies should evaluate cost efficiency and asset utilization effectiveness separately to obtain a more comprehensive understanding of managerial performance. These findings are limited to six profitable listed companies and should not be generalized to the entire Indonesian pharmaceutical industry.
Article Details
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
References
Abbas, S., Tabasum Khan, I., Junaid Ali, S., Munir, W., Khawar, H., Seemab Amin, Z., & Nida Shehzadi, H. (2023). Dyslipidemia In Type 2 Diabetes Mellitus Patients. In Journal of Survey in Fisheries Sciences (Vol. 10, Number 3).
Abdallah, M., Nesseem, D. I., Elgazayerly, O. N., & Abdelbary, A. A. (2021). Topical Delivery Of Quercetin Loaded Transfersomes For Wound Treatment: In Vitro And In Vivo Evaluation Original Article. https://doi.org/10.22159/ijap.2021v13i5.41435
Abdallah, S. I., Abubaker, N. E., Ibrahim, M. A., Abd Alla, A., & Humaida, R. A. (2024). Plasma glucose, HbA1c, insulin and lipid profile in Sudanese type 2 diabetic patients with cardiovascular disease: a case control study. F1000Research, 11, 472. https://doi.org/10.12688/f1000research.110927.1
Abdissa, D., & Hirpa, D. (2022). Dyslipidemia and its associated factors among adult diabetes outpatients in West Shewa zone public hospitals, Ethiopia. BMC Cardiovascular Disorders, 22(1). https://doi.org/10.1186/s12872-022-02489-w
Abukhelaif, A. E., Alghamdi, A. H., Saeed Saadi Alghamdi, K., Rashed Tami Alghamdi, O., & safer Alghamdi, M. (2024). Prevalence and Pattern of Dyslipidemia among Patients with Type II Diabetes in Al-Baha, Saudi Arabia. Afr. J. Biomed. Res, 27(4s), 6860–6865. https://doi.org/10.53555/AJBR.v27i4S.4887
Adam, L. N. (2025). Association between dyslipidemia and glycated hemoglobin in diabetic patients from Zakho General Hospital, Iraq. The Egyptian Journal of Internal Medicine, 37(1). https://doi.org/10.1186/s43162-025-00460-7
Addis, Z., Nega, A. T., Tebeje, R. D., Asmare, E., Tegegnie, A. B., Tamir, W., & Alene, T. (2024). Dyslipidemia and associated factors among adult type two diabetes mellitus patients in Felege Hiywot Refral, Hospital, Bahir Dar, Ethiopia, 2023. Frontiers in Cardiovascular Medicine, 11. https://doi.org/10.3389/fcvm.2024.1493447
Ahmmed, M. S., Shuvo, S. Das, Paul, D. K., Karim, M. R., Kamruzzaman, M., Mahmud, N., Ferdaus, M. J., & Elahi, M. T. (2021). Prevalence of dyslipidemia and associated risk factors among newly diagnosed Type-2 Diabetes Mellitus (T2DM) patients in Kushtia, Bangladesh. PLOS Global Public Health, 1(12). https://doi.org/10.1371/journal.pgph.0000003
Bakhtiar, M. I., Yudhistirawati, N., & Hamzah, H. (2023). Analisis Drps Statin Dan Estimasi Risiko Atherosclerotic Cardiovascular Disease (Ascvd) Pasien Diabetes Melitus Tipe 2 Rawat Jalan Di Rs “X” Samarinda (Vol. 6, Number 2). Online. https://jurnal.uimedan.ac.id/index.php/JURNALFARMASI85Journalhomepage:https://jurnal.uimedan.ac.id/index.php/JURNALFARMASI
Beshyah, S. A. (2025). Atherosclerotic Cardiovascular Diseases in Type 2 Diabetes in the Middle East and Africa: Insights from the PACT-MEA Study. Journal of Diabetes and Endocrine Practice, 08(04), 204–209. https://doi.org/10.1055/s-0045-1811602
Bui, L., Le, T. T., Dao, N. H., Nguyen, H. T., Nguyen, T. T., Pham, V. T. T., Cao, T. T. B., Nguyen, P. T., & Dong, P. T. X. (2026). Statin prescribing patterns in cardiovascular risk management among outpatients with type 2 diabetes: Real-world practices at a Vietnamese general hospital. PloS One, 21(2), e0343313. https://doi.org/10.1371/journal.pone.0343313
Cebrián-Cuenca, A. M., Mata-Cases, M., Franch-Nadal, J., Mauricio, D., Orozco-Beltrán, D., & Consuegra-Sánchez, L. (2021). Half of patients with type 2 diabetes mellitus are at very high cardiovascular risk according to the ESC/EASD: data from a large Mediterranean population. European Journal of Preventive Cardiology, 28(18), E32–E34. https://doi.org/10.1093/eurjpc/zwaa073
Choi, J. H., Lee, K. A., Moon, J. H., Chon, S., Kim, D. J., Kim, H. J., Kim, N. H., Seo, J. A., Kim, M. K., Lim, J. H., Song, Y. J., Yang, Y. S., Kim, J. H., Lee, Y. Bin, Noh, J., Hur, K. Y., Park, J. S., Rhee, S. Y., Kim, H. J., … Moon, M. K. (2023). 2023 Clinical Practice Guidelines for Diabetes Mellitus of the Korean Diabetes Association. In Diabetes and Metabolism Journal (Vol. 47, Number 5, pp. 575–594). Korean Diabetes Association. https://doi.org/10.4093/dmj.2023.0282
Çiçekli, A., & Sağlan, Y. (2026). Challenges in achieving low-density lipoprotein targets: a cross-sectional study in statin users. Turkish Journal of Family Practice, 30(1), 40–52. https://doi.org/10.54308/turkjfampract.2026.888
Das, A. K., Saboo, B., & Unnikrishnan, A. G. (2021). Current practices and gaps in management of dyslipidemia in type 2 diabetes mellitus (T2dm) in accordance with american diabetes association (ada) guidelines: A subset analysis from a real-world, cross-sectional observational study (leadd study). Diabetes, Metabolic Syndrome and Obesity, 14, 2693–2700. https://doi.org/10.2147/DMSO.S294842
Davies, M. J., Aroda, V. R., Collins, B. S., Gabbay, R. A., Green, J., Maruthur, N. M., Rosas, S. E., Del Prato, S., Mathieu, C., Mingrone, G., Rossing, P., Tankova, T., Tsapas, A., & Buse, J. B. (2022). Management of Hyperglycemia in Type 2 Diabetes, 2022. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care, 45(11), 2753–2786. https://doi.org/10.2337/dci22-0034
Dhaba, F. A., Alemu, W. A., Kitila, F. L., Tolla, K. S., Alene, A., Wendimagegn, Z. S., Getahun, K. A., Yesuf, H. A., & Woldeyes, S. M. (2025). Statin utilization and its predictors for the primary prevention of cardiovascular disease among type 2 diabetic patients in a resource-limited setting. Frontiers in Endocrinology, 16. https://doi.org/10.3389/fendo.2025.1472300
Fildza, I. Z., Farnandi, R., Harsep, D. R., & Deswati. (2025). Profil Penggunaan Statin Terhadap Risiko Atheroschlerosis Cardiovascular Disease Pada Pasien Rawat. Journal of Science and Clinical Pharmacy Research (JSCPR), 1.
Gyldenkerne, C., Mortensen, M. B., Kahlert, J., Thrane, P. G., Warnakula Olesen, K. K., Sørensen, H. T., Thomsen, R. W., & Maeng, M. (2023). 10-Year Cardiovascular Risk in Patients With Newly Diagnosed Type 2 Diabetes Mellitus. Journal of the American College of Cardiology, 82(16), 1583–1594. https://doi.org/10.1016/j.jacc.2023.08.015
Haile, K., & Timerga, A. (2020). Dyslipidemia and its associated risk factors among adult type-2 diabetic patients at jimma university medical center, Jimma, Southwest Ethiopia. Diabetes, Metabolic Syndrome and Obesity, 13, 4589–4597. https://doi.org/10.2147/DMSO.S283171
Hyassat, D., Al-Saeksaek, S., Naji, D., Mahasneh, A., Khader, Y., Abujbara, M., El-Khateeb, M., & Ajlouni, K. (2022). Dyslipidemia among patients with type 2 diabetes in Jordan: Prevalence, pattern, and associated factors. Frontiers in Public Health, 10. https://doi.org/10.3389/fpubh.2022.1002466
Kassam, N., Surani, S., Hameed, K., Aghan, E., Mayenga, R., Matei, I., Jengo, G., Bakshi, F., Mbithe, H., Orwa, J., Udeani, G., & Somji, S. (2023). Magnitude, Distribution and Contextual Risk Enhancing Predictors of High 10-Year Cardiovascular Risk Among Diabetic Patients in Tanzania. Patient Related Outcome Measures, Volume 14, 87–96. https://doi.org/10.2147/prom.s405392
Kaze, A. D., Santhanam, P., Musani, S. K., Ahima, R., & Echouffo-Tcheugui, J. B. (2021). Metabolic dyslipidemia and cardiovascular outcomes in type 2 diabetes mellitus: Findings from the look ahead study. Journal of the American Heart Association, 10(7). https://doi.org/10.1161/JAHA.120.016947
Kelnerin, K., Sudirga, P., Agung, A., Budhitresna, G., & Dewi, R. (2024). Hubungan antara Kadar HbA1c dengan Dislipidemia pada Pasien Diabetes Melitus Tipe II di RSUD Sanjiwani Gianyar. Aesculapius Medical Journal |, 4(3).
Khadka, B., Pandey, S., & Kafle, D. (2023). Dyslipidemia among Patients with Type 2 Diabetes Mellitus Visiting a Tertiary Care Centre. Journal of the Nepal Medical Association, 61(266), 758–761. https://doi.org/10.31729/jnma.8306
Kidwai, S. S., Nageen, A., Bashir, F., & Ara, J. (2020). HbA1c – a predictor of dyslipidemia in type 2 diabetes mellitus. Pakistan Journal of Medical Sciences, 36(6), 1339–1343. https://doi.org/10.12669/pjms.36.6.2000
Koohi, F., Kohansal, K., Naz, M. S. G., Derakhshan, S., Azizi, F., & Khalili, D. (2022). The trend of 10-year cardiovascular risk among diabetic and non-diabetic participants in Tehran Lipid and glucose study: 1999–2018. BMC Public Health, 22(1). https://doi.org/10.1186/s12889-022-12981-9
Luca, S. A., Bungau, R. M., Lazar, S., Potre, O., & Timar, B. (2024). To What Extent Does Cardiovascular Risk Classification of Patients with Type 2 Diabetes Differ between European Guidelines from 2023, 2021, and 2019? A Cross-Sectional Study. Medicina (Lithuania), 60(2). https://doi.org/10.3390/medicina60020334
Makhmudova, U., Samadifar, B., Maloku, A., Haxhikadrija, P., Geiling, J. A., Römer, R., Lauer, B., Möbius-Winkler, S., Otto, S., Schulze, P. C., & Weingärtner, O. (2023). Intensive lipid-lowering therapy for early achievement of guideline-recommended LDL-cholesterol levels in patients with ST-elevation myocardial infarction (“Jena auf Ziel”). Clinical Research in Cardiology, 112(9), 1212–1219. https://doi.org/10.1007/s00392-022-02147-3
Masal, K. P. (2023). Gambaran Dislipidemia Pada Pasien Diabetes Melitus Tipe 2 di RSUD Doris Sylvanus Palangka Raya. Malahayati Nursing Journal, 5(7), 2064–2069. https://doi.org/10.33024/mnj.v5i7.9022
Mehta, R. K., Koirala, P., Mallick, R. L., Parajuli, S., & Jha, R. (2021). Dyslipidemia in patients with type 2 diabetes mellitus in a tertiary care centre: A descriptive cross-sectional study. Journal of the Nepal Medical Association, 59(236), 305–309. https://doi.org/10.31729/JNMA.6278
Metsärinne, K., Pietilä, M., Kantola, I., Stenman, L. K., Hätinen, O. P., Vesikansa, A., Poussa, T., & Niskanen, L. (2022). The majority of type 2 diabetic patients in Finnish primary care are at very high risk of cardiovascular events: A cross-sectional chart review study (STONE HF). Primary Care Diabetes, 16(1), 135–141. https://doi.org/10.1016/j.pcd.2021.12.012
Mochu, M. U., Osias, K., Nnorom, F. I., Fakoya, O., Adebayo, A. A., Nathan-Otu, E., & Emanemua, C. E. (2025). Prevalence and Factors Associated With Dyslipidemia Among Adults With Type 2 Diabetes: Insights From the National Health and Nutrition Examination Survey (NHANES) 2009-2018. Cureus. https://doi.org/10.7759/cureus.96124
Parak, A., Daya, R., & Bayat, Z. (2025). Lipid profile of patients with uncontrolled type 2 diabetes mellitus at a tertiary South African hospital. Journal of Endocrinology, Metabolism and Diabetes of South Africa, 30(2), 27–32. https://doi.org/10.1080/16089677.2025.2480408
Pasinggi, M., & Baharuddin Pakki, I. (2025). The Relationship Between Lipid Profile And Hba1c Levels In Type 2 Diabetes Melitus Patients. Indonesian Journal of Global Health Research, 7. https://doi.org/10.37287/ijghr.v7i5.6629
Patel, S. B., Belalcazar, L. M., Afreen, S., Balderas, R., Hegele, R. A., Karpe, F., Ponte-Negretti, C. I., & Rajpal, A. (2025). American Association of Clinical Endocrinology Consensus Statement: Algorithm for Management of Adults with Dyslipidemia – 2025 Update. Endocrine Practice, 31(10), 1207–1238. https://doi.org/10.1016/j.eprac.2025.07.014
Ratnasari, P. M. D., Andayani, T. M., & Endarti, D. (2019). Analisis Kualitas Hidup Pasien Diabetes Melitus Tipe 2 Berdasarkan Pola Peresepan Antidiabetik dan Komplikasi. JURNAL MANAJEMEN DAN PELAYANAN FARMASI (Journal of Management and Pharmacy Practice), 9(4), 260. https://doi.org/10.22146/jmpf.45862
Sharahili, A. Y., Mir, S. A., ALDosari, S., Manzar, M. D., Alshehri, B., Al Othaim, A., Alghofaili, F., Madkhali, Y., Albenasy, K. S., & Alotaibi, J. S. (2023). Correlation of HbA1c Level with Lipid Profile in Type 2 Diabetes Mellitus Patients Visiting a Primary Healthcare Center in Jeddah City, Saudi Arabia: A Retrospective Cross-Sectional Study. Diseases, 11(4). https://doi.org/10.3390/diseases11040154
Unnikrishnan, A. G., Sahay, R. K., Phadke, U., Sharma, S. K., Shah, P., Shukla, R., Viswanathan, V., Wangnoo, S. K., Singhal, S., John, M., Kumar, A., Dharmalingam, M., Jain, S., Shaikh, S., & Verberk, W. J. (2022). Cardiovascular risk in newly diagnosed type 2 diabetes patients in India. PLoS ONE, 17(3 March). https://doi.org/10.1371/journal.pone.0263619
Vrablík, M., Sarkanová, I., Breciková, K., Šedová, P., Šatný, M., & Tichopád, A. (2023). Low LDL-C goal attainment in patients at very high cardiovascular risk due to lacking observance of the guidelines on dyslipidaemias. PLoS ONE, 18(5 May). https://doi.org/10.1371/journal.pone.0272883
Wati, A. L., & Mutmainah, N. (2026). Evaluasi Drug Related Problems Pada Pasien Rawat Inap Dislipidemia Dengan Terapi Statin Di Rumah Sakit Surakarta Evaluation Of Drug Related Problems Inpatients With Dyslipidemia On Statin Therapy At Surakarta Hospital. Usadha: Journal of Pharmacy, 5(1). https://jsr.lib.ums.ac.id/index.php/ujp