Beyond statin therapy: a review of the management of residual risk in diabetes mellitus

J R Soc Med. 2010 Sep;103(9):357-62. doi: 10.1258/jrsm.2010.100033.

Abstract

Total cholesterol and low-density lipoprotein (LDL) cholesterol exhibit an independent, strong, continuous correlation with cardiovascular events. The effectiveness of hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins) in the treatment and prevention of atherosclerosis is well-established. However, despite the lowering of LDL targets and the increased use of statins, patients with type 2 diabetes mellitus (DM) continue to experience a higher proportion of adverse coronary artery disease events. This is as a result of an atherogenic dyslipidaemia, characterized by low levels of high-density lipoprotein and elevated plasma triglyceride concentrations, often with high levels of cholesterol-rich remnant particles. This article will review dyslipidaemia and its role in DM, and will discuss available treatment modalities that address residual cardiovascular risk in this disease.

Publication types

  • Review

MeSH terms

  • Atherosclerosis / prevention & control*
  • Clofibric Acid / therapeutic use*
  • Diabetes Complications / drug therapy*
  • Diabetes Mellitus / drug therapy
  • Drug Therapy, Combination
  • Dyslipidemias / complications
  • Dyslipidemias / drug therapy*
  • Fatty Acids, Omega-3 / therapeutic use*
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use*
  • Niacin / therapeutic use*

Substances

  • Fatty Acids, Omega-3
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Niacin
  • Clofibric Acid