[Weight reduction, statins or fibrates? How to reach lipid goal values in diabetic patients]

Diabetics have a greatly increased risk for cardiovascular disease. At the center of the pathogenesis is the elevated blood sugar, insulin resistance and hyperinsulinemia. Treatment must therefore be aimed at controlling glucose metabolism (HBA1c < 7.0%) and lipid metabolism (LDL conc < 100 mg/dL, triglycerides < 150 mg/dL). Blood pressure should not exceed 130/85 mmHg. In addition to changes in lifestyle--low-fat, calorie-controlled diet and increased physical activity--lipid-lowering medication can rarely be done without. On the basis of the results of large interventional studies, the CSE inhibitors are particularly to be recommended. While the domain of the fibrates is the lowering of triglycerides, no comparative data on the usefulness of this group of substances are currently available.