Therapy and clinical trials: Management of diabetic dyslipidemia

Current Opinion in Lipidology

Volumn 20, Issue 1, 2009, Pages 85-86

  Jialal, Ishwarlal ^a   Bajaj, Mandeep ^b  

^a UNIVERSITY OF CALIFORNIA   (United States)

^b BAYLOR COLLEGE OF MEDICINE   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

COLESEVELAM; FENOFIBRATE; FIBRIC ACID DERIVATIVE; HYDROXYMETHYLGLUTARYL COENZYME A REDUCTASE INHIBITOR; NICOTINIC ACID;

CARDIOVASCULAR RISK; CLINICAL TRIAL; DIABETES MELLITUS; DRUG EFFECT; DRUG SAFETY; DYSLIPIDEMIA; EDITORIAL; HUMAN; LIFESTYLE MODIFICATION; MONOTHERAPY; PRIORITY JOURNAL; TREATMENT OUTCOME;

CLINICAL TRIALS AS TOPIC; DIABETES MELLITUS, TYPE 2; DYSLIPIDEMIAS; HUMANS; RISK;

EID: 58849146223     PISSN: 09579672     EISSN: None     Source Type: Journal    
DOI: 10.1097/MOL.0b013e32832210b0     Document Type: Editorial

References (18)

1. Collins R, Armitage J, Parish S, et al. MRC/BHF heart protection study of cholesterol-lowering with simvastatin in 5963 people with diabetes: a randomised placebo-controlled trial. Lancet 2003; 361:2005-2016.
2. Colhoun HM, Betteridge DJ, Durrington PN, et al. Primary prevention of cardiovascular disease with Atorvastatin in type II diabetes in the Collaborative Atorvastatin Diabetes Study (CARDS): multicentre randomised placebo- controlled trial. Lancet 2004; 364:685-696.
3. Cholesterol Treatment Trialist' (CTT) Collaborators. Efficacy of cholesterol- •• lowering therapy in 18686 people with diabetes in 14 randomised trails trials of statins. Lancet 2008; 371:117-125.
4. This is an excellent meta-analysis of 14 randomized trials including 18686 patients with diabetes that clearly shows a significant reduction in all-cause mortality and cardiovascular mortality with statin therapy. The disappointment of this trial is that both the ASPEN and the German Diabetes and Dialysis Study were excluded from the analysis by the authors but discussed. It would have been interesting if both of these negative studies were included in the meta-analysis. It was also important to emphasize that 92% of the patients in these studies had type II diabetes.
5. Karalis DG. The role of lipid-lowering therapy in preventing coronary heart • disease in patients with type 2 diabetes. Clin Cardiol 2008; 31:241- 248.
6. This is a nice up-to-date review on the importance of initiating statin therapy based on the large clinical trials in patients with diabetes. Furthermore, the author suggests that serious consideration should be given to niacin-statin therapy in patients with diabetes.
7. Brown BG, Xue-Qiao Z, Chart A, et al. Simvastatin and niacin, antioxidant vitamins, or the combination for the prevention of coronary disease. N Engl J Med 2008; 345:1583-1592.
8. Taylor AJ, Lee HJ, Sullenberger LE. The effect of 24 mo of combination statin •• and extended-release niacin on carotid intimamedia thickness: ARBITER 3.
9. Curr Med Res Opin 2006; 22:2243-2250. In this important study using carotid intima-media thickness, Taylor and his colleague's show that over a 2-year period there was a significant reduction in carotid intima-media thickness with a combination of extended release Niacin- statin therapy compared to statin therapy alone.
10. Steinmertz A. Lipid-lowering therapy in patients with type 2 diabetes: the case • for early intervention. Diabetes Metab Res Rev 2008; 24:286-293.
11. In this study the author does an excellent review on the statin trials in diabetic patients including the negative trials; furthermore, for residual risk, he makes a strong rational based on the benefit in the FIELD study on both a secondary end point and on microvascular complications that fenofibrate therapy should be considered in addition to statin therapy in optimizing the lipid profile and reducing residual risk in type II diabetes.
12. Knopp RH, D'Emden M, Smilde JG, et al. Efficacy and safety of atorvastatin in the prevention of cardiovascular endpoints in subjects with type 2 diabetes. The Atorvastatin Study for Prevention of Coronary Heart Disease Endpoints in Noninsulin-Dependent Diabetes Mellitus (ASPEN). Diabetes Care 2008; 29:1478-1485.
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14. The FIELD study investigators. Effect of long-term fenofibrate therapy on cardiovascular events in 9795 people with type 2 diabetes mellitus (the FIELD study): randomised controlled trial. Lancet 2005; 366:1849-1861.
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16. 1c, and LDL-C in patients with type II diabetes on hypoglycemic agents.
17. Bunzell JD, Davidson M, Furberg CD, et al. Lipoprotein management in • patients with cardiometabolic risk. J Am Coll Cardiol 2008; 51:1512- 1524.
18. The recent guideline with regards to lipid management in patients with cardiometabolic risk brings into play the relevance of targeting both non-HDL-C and Apo-B levels in patients with increased cardiometabolic risk such as metabolic syndrome and type II diabetes.