Dyslipoproteinemia and diabetes

Dyslipidemia in patients with diabetes constitutes quantitative and qualitative abnormalities in all classes of lipoproteins and may be a significant contributor to the high risk of atherosclerosis in these patients. A step-care approach to therapy of diabetic dyslipidemia, including hygienic measures (diet and increased physical activity), hypoglycemic drugs, and lipid-lowering drugs, is recommended. The choice of lipid-lowering drugs depends on severity of hypertriglyceridemia. Statins and bile-acid-binding resins are the choice of therapy for diabetic dyslipidemia; however, for severely hypertriglyceridemic patients, fibric acid derivatives should be used. Nicotinic acid worsens hyperglycemia and, therefore, should be avoided. The value of estrogen replacement therapy in postmenopausal women with diabetes has not been established.