Pharmacological management of diabetic dyslipidaemia

Česká verzia

Authors: Ľubomíra Fábryová
Authors place of work: Metabol KLINIK s. r. o., Ambulancia pre diabetológiu, poruchy látkovej premeny a výživy, Bratislava
Published in the journal: Forum Diab 2017; 6(3): 155-163
Category: Topic

Summary

Cardiovascular diseases are extremely common in type 2 diabetics. This is due to the presence of characteristic atherogenic dyslipidemia, which significantly contributes to increased cardiovascular risk. Atherogenic dyslipidemia is associated with a worse cardiovascular prognosis, but its management, especially treatment options that lead to a decrease in residual risk, are often ignored in clinical practice. The primary goal of treating diabetic dyslipidemia is to reduce LDL-cholesterol by statins, and diabetics not achieving LDL-cholesterol targets can add ezetimibe to treatment, which further reduces not only LDL-cholesterol but also cardiovascular risk. For diabetic patients achieving LDL-cholesterol targets with statin and/or ezetimibe with atherogenic dyslipidemia addition of fenofibrate leads to further improvement of lipid abnormalities with possible risk reduction. Treatment with fenofibrate is also very useful in diabetic patients with microvascular complications. A new promises for diabetics at very high cardiovascular risk are PCSK9 inhibitors. The management of atherogenic dyslipidemia, in addition to primary LDL-cholesterol management, presents a higher chance of reducing residual cardiovascular risk in an increasingly large group of type 2 diabetics.

Key words:
atherogenic dyslipidemia, cardiovascular disease, ezetimibe, fenofibrate, PCSK9 inhibitors, pemafibrate, statins

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