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Management of Diabetic Dyslipidemia

Need for Reappraisal of the Goals

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Abstract

Cardiovascular disease is the leading cause of mortality among people with diabetes mellitus, accounting for 70% of all deaths. As the prevalence of diabetes increases significantly worldwide, greater attention must be focused on preventing cardiovascular events in this group. One contributor to this increased event rate is the characteristic pattern of dyslipidemia in diabetic patients, consisting of elevated serum triglyceride levels, decreased high-density lipoprotein levels, and an increased proportion of small, dense, low-density lipoproteins. Several pharmacologic agents have been used to treat this dyslipidemia including HMG-CoA reductase inhibitors, fibric acid derivatives, niacin (nicotinic acid), thiazolidinediones, and fish oils, as well as other non-pharmacologic measures. Currently, the most extensive data for a reduction in cardiovascular events in patients with diabetes exist for HMG-CoA reductase inhibitors. The results of these trials indicate that HMG-CoA reductase inhibitor therapy should be considered for all patients with diabetes at sufficient risk for cardiovascular events, regardless of serum low-density lipoprotein-cholesterol level. Several ongoing trials of various pharmacologic agents should help clarify the role of these agents alone and in combination with HMG-CoA reductase inhibitors in the management of diabetic dyslipidemia.

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Acknowledgments

The preparation of this manuscript was supported by funding from the Donald W. Reynolds Foundation. Dr McGuire has received honoraria from Takeda and Pfizer, research support from Pfizer and Glaxo Smith Kline, and is a consultant to Takeda and Sankyo.

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  1. Division of Cardiology and the Donald W. Reynolds Cardiovascular Clinical Research Center, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390-9047, USA

    Amit Khera &  Darren K. McGuire

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Khera, A., McGuire, D.K. Management of Diabetic Dyslipidemia. Am J Cardiovasc Drugs 5, 83–91 (2005). https://doi.org/10.2165/00129784-200505020-00002

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