Managing dyslipidemia in patients with type 2 diabetes

Expert Opin Pharmacother. 2021 Apr 6. doi: 10.1080/14656566.2021.1912734. Online ahead of print.ABSTRACTINTRODUCTION: Type 2 diabetes mellitus (T2DM) is associated with increased risk for atherosclerotic cardiovascular disease (ASCVD) which is partly related to the atherogenic dyslipidemia with raised triglycerides, reduced high-density lipoprotein cholesterol levels and accompanying lipid changes. Treatment of this dyslipidemia is regarded as a priority to reduce the ASCVD risk in T2DM.AREAS COVERED: In this article, the authors review the relevant studies and guidelines from the publications related to this area.EXPERT OPINION: Lifestyle modification should always be encouraged, and statin treatment is indicated in most patients with T2DM based on the outcome of randomized controlled trials. If LDL-C goals are not achieved, firstly ezetimibe and subsequently proprotein convertase subtilisin-kexin type 9 (PCSK9) inhibitors should be added. Patients with T2DM derive greater benefits from ezetimibe and PCSK9 inhibitors due to their higher absolute ASCVD risk compared to patients without T2DM. If triglyceride levels remain elevated, high dose eicosapentaenoic acid ethyl ester should be added. Fibrates should be used for severe hypertriglyceridemia to prevent acute pancreatitis. Novel treatments including pemafibrate and inclisiran are undergoing cardiovascular outcome trials and RNA-based therapies may help to target residual hypertriglyceridemia and high lipoprotein(a) with th...
Source: Expert Opinion on Pharmacotherapy - Category: Drugs & Pharmacology Authors: Source Type: research