The current management of diabetic dyslipidaemia

Compared with non-diabetic individuals, patients with diabetes have a two- to four-fold greater risk of myocardial infarction, and growing evidence suggests that dyslipidaemia contributes significantly to this excess risk. Based on evidence from the major trials of HMG-CoA reductase inhibitors (statins), the American Diabetes Association have published updated guidelines that outline priorities for the treatment of diabetic dyslipidaemia. These guidelines emphasise that low density lipoprotein (LDL) cholesterol is the first priority for lipid lowering. All diabetic patients with, or at risk of, coronary heart disease (CHD) should be treated to an LDL cholesterol goal of < or = 2.6 mmol/L (100 mg/dL). The recent Joint European Task Force on Coronary Prevention recommend similar goals: total cholesterol <5.0 mmol/L (190 mg/dL) and LDL cholesterol <3.0 mmol/L (115 mg/dL). Both the ADA and Joint European Task Force recommend statins as first choice hypolipidaemic therapy for patients with diabetic dyslipidaemia. Ongoing trials will provide further evidence of the benefits of lipid-lowering therapy with statins in reducing CHD risk in patients with type 2 diabetes. Results from these studies will likely add further support to the recommendations to use statins in the overall management of diabetic patients.