Article

Current Diabetes Reports

, Volume 10, Issue 4, pp 316-320

Open Access This content is freely available online to anyone, anywhere at any time.

Management of Hypertriglyceridemia in the Diabetic Patient

  • Ishwarlal JialalAffiliated withVA Medical Center and Laboratory for Atherosclerosis and Metabolic Research, Department of Pathology and Internal Medicine, UC Davis Medical Center Email author 
  • , William AmessAffiliated withVA Medical Center and Laboratory for Atherosclerosis and Metabolic Research, Department of Pathology and Internal Medicine, UC Davis Medical Center
  • , Manpreet KaurAffiliated withVA Medical Center and Laboratory for Atherosclerosis and Metabolic Research, Department of Pathology and Internal Medicine, UC Davis Medical Center

Abstract

The hypertriglyceridemia of diabetes can be classified into mild to moderate (triglycerides between 150–499 mg/dL) and severe hypertriglyceridemia (triglycerides ≥500 mg/dL). As in any other individuals with hypertriglyceridemia, secondary causes need to be excluded. The management of severe hypertriglyceridemia (chylomicronemia syndrome) includes aggressive reduction of triglycerides with intravenous insulin, fibrates, omega-3 fatty acids, and/or niacin therapy to avert the risk of pancreatitis. In patients with mild to moderate hypertriglyceridemia, the treatment of choice is statin therapy to achieve the low-density lipoprotein (LDL) and non-high-density lipoprotein (HDL) target goals. The evidence base would favor niacin therapy in combination with statin therapy to achieve the goals pertaining to LDL cholesterol and non-HDL cholesterol. The data about the combination of fibrate therapy with statin therapy are disappointing.

Keywords

Hypertriglyceridemia Diabetes Dyslipidemia Statins Niacin Fibrates