Dyslipidemia as a risk factor for coronary disease in patients with diabetes

To highlight the frequency of lipid abnormalities in patients with diabetes and the need for appropriate treatment strategies for coronary disease.

The epidemiologic features of coronary artery disease in the diabetic population are reviewed, and the pathogenesis of atherosclerotic disease is discussed. Various risk factors for predicting coronary artery disease and guidelines for therapeutic intervention are presented.

The American Diabetes Association has estimated that 60% of all adults will die of coronary artery disease and that 80% of patients with diabetes will ultimately have atherosclerosis. The accelerated rate of atherosclerosis in patients with diabetes may be attributable to several factors, including hyperglycemia and insulin resistance. Abnormalities in lipid metabolism have a major role in the development of coronary disease. Because the National Cholesterol Education Program guidelines for treatment were established for less complicated hyperlipidemias, The American Diabetes Association recommends more aggressive lipid-lowering therapy at a lower level of low-density lipoproteins (130 mg/dL or 3.36 mmol/L) to produce an equivalent reduction in risk of coronary disease in patients with diabetes.

In patients with diabetes, lipid levels should be aggressively reduced to decrease the possibility of coronary artery disease.