Cardiovascular Disease Risk of Type 2 Diabetes Mellitus and Metabolic Syndrome: Focus on Aggressive Management of Dyslipidemia

Author(s): James M. Falko, Robert J. Moser, Sophia B. Meis, Teresa Caulin-Glaser.

Journal Name: Current Diabetes Reviews

Volume 1 , Issue 2 , 2005

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Abstract:

Type 2 diabetes mellitus and the closely related metabolic syndrome markedly increase the risk of cardiovascular disease a major contributor is the dyslipidemia. Recent studies and new national guidelines suggest these very high risk patients with cardiovascular disease achieve optional low density lipoprotein cholesterol (LDL-C) level of less than 70mg/dl. In addition there may be no threshold to begin therapeutic lifestyle change and pharmacologic therapy to reduce LDL-C by 30-40%. Although randomized controlled trials with statins indicate that LDL reduction clearly reduces cardiovascular risk in these patients, the typical dyslipidemia of type 2 diabetes mellitus is also characterized by low high density lipoprotein cholesterol (HDL-C) levels, increased triglyceride-rich lipoproteins and small dense LDL, as well as increased postprandial lipemia. The later lipoproteins increase non-HDL-C levels. In order to address these abnormalities it may be necessary to utilize combined approaches with a fibrate or nicotinic acid, or other agents with statins to help reduce risk beyond statins. In addition, supervised, therapeutic life-style change is often underutilized therapy in patients with established coronary artery disease. This review will focus on maximizing the treatment of dyslipidemia in type 2 diabetes and the metabolic syndrome and discuss the evidence based studies and new developments in the management in these very high risk patients.

Keywords: type diabetes mellitus, dyslipidemia, metabolic syndrome, therapy

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Article Details

VOLUME: 1
ISSUE: 2
Year: 2005
Page: [127 - 135]
Pages: 9
DOI: 10.2174/1573399054022848
Price: $58

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