Lipids and diabetes

Journal of Clinical and Basic Cardiology 2000; 3 (3): 159-162

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Keywords: Atherosklerose,  Fibrate,  kardiovaskuläre Mortalität,  Statin,  atherosclerosis,  cardiovascular mortality,  fibrates,  Statin

Atherosclerosis is a major complication of diabetes being responsible for the increased morbidity and mortality in these patients. Diabetic dyslipidaemia comprises elevated triglyceride levels as well as decreased HDL cholesterol levels. LDL cholesterol is quantitatively not significantly different from non-diabetic subjects, however, there is a preponderance of small dense LDL particles with a greater susceptibility to oxidation. Epidemiological studies have shown that patients with type-2 diabetes mellitus with no history of cardiovascular disease, have the same risk for cardiac events as non-diabetic patients with pre-existing coronary disease have. The increased incidence of cardiovascular disease (CVD) in diabetes, the greater case fatality and 1-year mortality in patients with myocardial infarction strongly suggest that preventive lipid lowering therapy is of great importance. Unfortunately, the rationale for prevention of CVD in patients with diabetes is obtained only from pathophysiological evidence, interventional studies in non-diabetic populations and post-hoc subgroup analyses in diabetic patients. Therefore, many questions regarding the therapy of diabetic dyslipidaemia still remain open. However, these studies suggest that lowering cholesterol in patients with type-2 diabetes is at least as effective as in a non-diabetic population. Results from prospective lipid lowering trials in patients with diabetes are therefore awaited with great interest. J Clin Basic Cardiol 2000; 3: 159-62.