Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2010 Dec 20;9:144.
doi: 10.1186/1476-511X-9-144.

Treatment of Dyslipidemia in Patients With Type 2 Diabetes

Affiliations
Free PMC article
Review

Treatment of Dyslipidemia in Patients With Type 2 Diabetes

Krishnaswami Vijayaraghavan. Lipids Health Dis. .
Free PMC article

Abstract

Type 2 diabetes is associated with significant cardiovascular morbidity and mortality. Although low-density lipoprotein cholesterol levels may be normal in patients with type 2 diabetes, insulin resistance drives a number of changes in lipid metabolism and lipoprotein composition that render low-density lipoprotein cholesterol and other lipoproteins more pathogenic than species found in patients without type 2 diabetes. Dyslipidemia, which affects almost 50% of patients with type 2 diabetes, is a cardiovascular risk factor characterized by elevated triglyceride levels, low high-density lipoprotein cholesterol levels, and a preponderance of small, dense, low-density lipoprotein particles. Early, aggressive pharmacological management is advocated to reduce low-density lipoprotein cholesterol levels, regardless of baseline levels. A number of lipid-lowering agents, including statins, fibrates, niacin, and bile acid sequestrants, are available to target normalization of the entire lipid profile. Despite use of combination and high-dose lipid-lowering agents, many patients with type 2 diabetes do not achieve lipid targets. This review outlines the characteristics and prevalence of dyslipidemia in patients with type 2 diabetes and discusses strategies that may reduce the risk of cardiovascular disease in this population.

Figures

Figure 1
Figure 1
Atherogenic dyslipidemia and changes in lipoprotein metabolism associated with type 2 diabetes mellitus [51]. Insulin resistance is associated with enhanced production of very-low-density lipoprotein (VLDL); a reduction in the catabolic rate of intermediate-density lipoprotein (IDL) and small, dense low-density lipoprotein (sdLDL); increased production of high-density lipoprotein (HDL) outweighed by increased catabolism. Adapted with permission from Adiels et al, Overproduction of very low-density lipoproteins is the hallmark of the dyslipidemia in the metabolic syndrome. Arterioscler Thromb Vasc Biol 28(7): 1225-1236 (2008) [14].
Figure 2
Figure 2
Prevalence of target low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglyceride (TG) levels for patients with and without type 2 diabetes mellitus (T2DM): National Health and Nutrition Examination Survey 1999-2000. *P <0.001 vs patients with T2DM. Reprinted from Diabetes Res Clin Pract, 70(3), Jacobs MJ, et al, 263-269, Copyright 2005, with permission from Elsevier [27].
Figure 3
Figure 3
Prevalence of target low-density lipoprotein cholesterol (LDL-C) and combined LDL-C, high-density lipoprotein cholesterol (HDL-C) + triglyceride (TG) levels for patients with type 2 diabetes mellitus either treated or not treated for dyslipidemia: National Health and Nutrition Examination Survey 1999-2000 [27].

Similar articles

See all similar articles

Cited by 16 articles

See all "Cited by" articles

References

    1. Centers for Disease Control and Prevention. National diabetes fact sheet. http://www.cdc.gov/diabetes/pubs/pdf/ndfs_2007.pdf
    1. United Kingdom Prospective Diabetes Study. Plasma lipids and lipoproteins at diagnosis of NIDDM by age and sex (UKPDS 27) Diabetes Care. 1997;20:1683–1687. doi: 10.2337/diacare.20.11.1683. - DOI - PubMed
    1. Kannel WB, McGee DL. Diabetes and cardiovascular disease. The Framingham study. JAMA. 1979;241:2035–2038. doi: 10.1001/jama.241.19.2035. - DOI - PubMed
    1. Saydah SH, Fradkin J, Cowie CC. Poor control of risk factors for vascular disease among adults with previously diagnosed diabetes. JAMA. 2004;291:335–342. doi: 10.1001/jama.291.3.335. - DOI - PubMed
    1. Stratton IM, Adler AI, Neil HA, Matthews DR, Manley SE, Cull CA, Hadden D, Turner RC, Holman RR. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. BMJ. 2000;321:405–412. doi: 10.1136/bmj.321.7258.405. - DOI - PMC - PubMed

Publication types

MeSH terms

Feedback