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The therapy for diabetes aims to alleviate hyperglycemia-related symptoms, prevent acute metabolic decompensation, and reduce chronic end-organ complications. Glycemic control is evaluated through short-term (self-monitoring, continuous glucose monitoring) and long-term (A1c, fructosamine) metrics, enabling near real-time tracking of blood glucose levels and reflecting glycemic control over specific time frames.
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Diabetes mellitus is a chronic metabolic disorder characterized by hyperglycemia. The four categories of diabetes are type 1 diabetes, type 2 diabetes, other specific types of diabetes, and gestational diabetes.
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For most patients, experiencing several weeks of polyuria, polydipsia, fatigue, and significant weight loss may indicate the presence of diabetes. Furthermore, adults displaying the phenotypic appearance of type 2 diabetes (particularly those who are obese and not initially insulin-requiring), may have islet cell autoantibodies, suggesting autoimmune-mediated β cell destruction and a diagnosis of latent autoimmune diabetes of adults (LADA). The categorization of glucose homeostasis is...
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Interaction Between Primary Hyperlipidemias and Type 2 Diabetes: Therapeutic Implications.

Rafael Zubirán1, Ivette Cruz-Bautista2, Carlos A Aguilar-Salinas3,4,5

  • 1Lipoprotein Metabolism Laboratory, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA.

Diabetes Therapy : Research, Treatment and Education of Diabetes and Related Disorders
|July 30, 2024
PubMed
Summary

Primary hyperlipidemias interacting with type 2 diabetes (T2D) significantly increases cardiovascular risk. This review updates knowledge on managing these conditions with new therapies.

Keywords:
Combined hyperlipidemiaDiabetesDiabetes complicationsDiabetes incidenceFamilial combined hyperlipidemiaFamilial dysbetalipoproteinemiaFamilial hypercholesterolemiaInteractionsLp(a)Multifactorial chylomicronemiaPrimary hyperlipidemiasType 2 diabetesType III hyperlipidemia

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Area of Science:

  • Cardiology
  • Endocrinology
  • Metabolic Disorders

Background:

  • The interaction between primary hyperlipidemias and type 2 diabetes (T2D) has significant clinical and pathophysiological implications.
  • Existing evidence is largely from cohort sub-analyses, with limited randomized clinical trial data.
  • T2D exacerbates the already high cardiovascular risk in patients with primary hyperlipidemias.

Purpose of the Study:

  • To review the clinical and pathophysiological implications of primary hyperlipidemias interacting with T2D.
  • To highlight the need for accurate patient identification and optimized lipid-lowering therapy prescription.
  • To provide an update on newer therapeutic options for managing this dual burden.

Main Methods:

  • Literature review focusing on interactions between primary hyperlipidemias and T2D.
  • Analysis of existing cohort data and randomized clinical trials.
  • Synthesis of current knowledge on cardiovascular risk escalation.

Main Results:

  • Primary hyperlipidemias, including familial combined hyperlipidemia, familial hypercholesterolemia, multifactorial chylomicronemia, and lipoprotein (a), are associated with increased cardiovascular risk when co-occurring with T2D.
  • T2D significantly amplifies the atherogenic dyslipidemia profile common in primary hyperlipidemias.
  • There is a critical need for evidence-based guidelines for managing lipid disorders in diabetic patients.

Conclusions:

  • The combined burden of primary hyperlipidemias and T2D necessitates a comprehensive understanding of their interactions.
  • Accurate identification and tailored lipid-lowering therapies are crucial for mitigating escalated cardiovascular risk.
  • Advancements in therapeutic options offer new avenues for managing patients with this dual metabolic challenge.