Management of diabetic dyslipidemia - what is new?

Abstract

Patients with diabetes mellitus or metabolic syndrome frequently have higher triglicerides, lower HDL cholesterol and more small dense LDL particles, and this combination contributes significantly to their cardiovascular risk. In addition to diet and exercise, statins remain the primary drugs of choice in patients with diabetic dyslipidemia. However statin therapy alone is often insufficient for managing cardiovascular diseases (CVD) and achieving target goals. Despite low LDL levels, the residual CVD risk for many patients is elevated. Low HDL cholesterol levels and high trigliceryde levels are important contributors to residual risk. For these patients combination lipid- modifying therapy may be recommended. Statin plus fibrate or niacin or omega-3 fatty acids may be considered. Combined lipid-lowering therapy could be anticipated to offer additional clinical benefits in patients with dyslipidemia. Data from prospective randomised trials are needed to evaluate the outcome benefits and tolerability of this kind of therapy.