Managing diabetic dyslipidemia: Beyond statin therapy

• Published in: Current diabetes reports 2009-02, Vol.9 (1), p.11-17
• Main Authors: Neeli, Hemanth, Gadi, Ram, Rader, Daniel J.
• Format: Article
• Language: English
• Subjects: Cholesterol, HDL - blood; Cholesterol, LDL - blood; Cholesterol, LDL - drug effects; Diabetes; Diabetes Complications - therapy; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - drug therapy; Diabetic Angiopathies - drug therapy; Diabetic Angiopathies - epidemiology; Diabetic Angiopathies - mortality; Dyslipidemias - drug therapy; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use; Hypertriglyceridemia - blood; Hypoglycemic Agents - therapeutic use; Hypolipidemic Agents - therapeutic use; Lipids - blood; Lipids - physiology; Lipoproteins, VLDL - blood; Medicine; Medicine & Public Health; Niacin - therapeutic use; PPAR alpha - agonists
• ISSN: 1534-4827; 1539-0829
• DOI: 10.1007/s11892-009-0004-y

Cardiovascular disease is a significant cause of morbidity and mortality in patients with diabetes mellitus. The lipid profile of type 2 diabetes mellitus is characterized by increased triglycerides (TGs), decreased high-density lipoprotein cholesterol (HDL-C), increased very low density lipoproteins (VLDLs), and small, dense low-density lipoprotein particles, the combination of which is highly atherogenic. In diabetic patients, current treatment guidelines target low-density lipoprotein cholesterol (LDL-C) ≤ 100 mg/dL with statins. In patients with elevated TGs, non-HDL-C is considered a secondary target of therapy. Despite the use of statin therapy in diabetes, a significant number of fatal and nonfatal coronary heart disease (CHD) events still occur, indicating the need to target other modifiable risk factors for CHD, including high TGs and low HDL-C.