Dyslipidemia Management in Adults With Diabetes

Publication date: Available online 12 July 2019Source: Canadian Journal of DiabetesAuthor(s): Julieta Lazarte, Robert A. HegeleAbstractLipid abnormalities beyond elevated low-density lipoprotein (LDL) cholesterol contribute to increased risk of atherosclerotic cardiovascular disease (ASCVD) in type 2 diabetes. We searched for English language randomized controlled trials of lipid-lowering therapies primarily since 2012 that included patients with diabetes. Diet and lifestyle advice are always a starting point for ASCVD prevention in diabetes. After almost 30 years of widespread clinical use in diabetes, statin treatment to reduce LDL cholesterol remains the cornerstone of drug therapy to prevent ASCVD. Ezetimibe appears to be particularly beneficial for high-risk statin-treated patients with diabetes. Similarly, currently available proprotein convertase subtilisin kexin type 9 inhibitors—alirocumab and evolocumab—both reduce ASCVD risk in statin-treated patients with diabetes. High-dose icosapent ethyl is another worthwhile add-on treatment, especially in statin-treated patients with diabetes in whom triglyceride levels remain elevated. Fibrates might reduce ASCVD risk in patients with diabetes with high triglyceride and low high-density lipoprotein cholesterol; however, fibrates are more strongly recommended for prophylaxis of pancreatitis in patients with severe hypertriglyceridemia and may also slow progression of diabetic retinopathy. Several existing and newer drug ...
Source: Canadian Journal of Diabetes - Category: Endocrinology Source Type: research