[Diabetic dyslipoproteinemia]

Diabetic dyslipoproteinemia is considered to be an integral component of type 2 diabetes mellitus and the metabolic syndrome. Major pathogenetic factors include abdominal obesity, insulin resistance and hyperglycemia with increased hepatic secretion of triglyceride-rich lipoproteins. Elevated concentrations of triglycerides and cholesterol, together with decreased HDL cholesterol are therefore found. LDL cholesterol is either normal or only slightly increased, but at the same time, the composition of the LDL particles is altered. This metabolic disorder contributes considerably to the clearly elevated cardiovascular risk. Dyslipoproteinemia, usually in the form of hypertriglyceridemia, may also occur in type 1 diabetes mellitus. Since general measures and good blood sugar control often fail to achieve the desired lipid levels, many patients require medication, initially usually statins, but, where necessary, combination treatment. In patients with isolated hypertriglyceridemia, treatment with fibrates may also be considered.