Reducing cardiovascular risk in patients with type 2 diabetes: Management of dyslipidemia

Jennifer Campbell, Daniel E. Hilleman

Research output: Contribution to journalReview article

2 Citations (Scopus)

Abstract

Cardiovascular disease (CVD) remains the leading cause of death in patients with diabetes mellitus, accounting for 50% of all deaths. Dyslipidemia is an important modifiable risk factor in diabetic patients and represents a key area for intervention in these patients. Diabetic patients have a lipid profile characterized by low high-density lipoprotein cholesterol (HDL-C) levels and an increase in triglyceride levels. Diabetics have increased numbers of low-density lipoprotein cholesterol (LDL-C) particles but with a shift to smaller, denser LDL-C particles. The net effect is that patients with type 2 diabetes do not have substantially higher LDL-C concentrations than patients without diabetes. Lifestyle modification with reductions in saturated fat, trans fat, and cholesterol intake, weight loss (if indicated), and increased physical activity are initially recommended to improve the lipid profile. In addition, enhanced glycemic control can improve plasma lipid levels, especially in patients with very high triglycerides. Statin therapy should be added to lifestyle therapy, regardless of baseline lipid levels for diabetic patients without overt CVD and for diabetics >40 years who have 1 or more other cardiovascular risk factors. For lower-risk patients without overt CVD 40 mg/dL in men and >50 mg/dL in women are desirable. If triglyceride and HDL-C targets are not achieved using statins, the use of a statin and other lipid-lowering therapy may be considered, but combination therapy has not been shown to reduce the risk of adverse cardiovascular events to an extent greater than that of a statin alone.

Original languageEnglish
Pages (from-to)124-134
Number of pages11
JournalFormulary
Volume45
Issue number4
StatePublished - Apr 2010

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Dyslipidemias
Type 2 Diabetes Mellitus
Hydroxymethylglutaryl-CoA Reductase Inhibitors
LDL Cholesterol
Lipids
HDL Cholesterol
Triglycerides
Cardiovascular Diseases
Life Style
Fats
Therapeutics
Weight Loss
Cause of Death
Diabetes Mellitus
Cholesterol
Exercise

All Science Journal Classification (ASJC) codes

  • Pharmacology (medical)

Cite this

Reducing cardiovascular risk in patients with type 2 diabetes : Management of dyslipidemia. / Campbell, Jennifer; Hilleman, Daniel E.

In: Formulary, Vol. 45, No. 4, 04.2010, p. 124-134.

Research output: Contribution to journalReview article

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