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Curr Diab Rep. 2010 Aug;10(4):316-20. doi: 10.1007/s11892-010-0124-4.

Management of hypertriglyceridemia in the diabetic patient.

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  • 1VA Medical Center and Laboratory for Atherosclerosis and Metabolic Research, Department of Pathology and Internal Medicine, UC Davis Medical Center, 4635 Second Avenue, Research 1 Building, Room 3000, Sacramento, CA 95817, USA.


The hypertriglyceridemia of diabetes can be classified into mild to moderate (triglycerides between 150-499 mg/dL) and severe hypertriglyceridemia (triglycerides > or =500 mg/dL). As in any other individuals with hypertriglyceridemia, secondary causes need to be excluded. The management of severe hypertriglyceridemia (chylomicronemia syndrome) includes aggressive reduction of triglycerides with intravenous insulin, fibrates, omega-3 fatty acids, and/or niacin therapy to avert the risk of pancreatitis. In patients with mild to moderate hypertriglyceridemia, the treatment of choice is statin therapy to achieve the low-density lipoprotein (LDL) and non-high-density lipoprotein (HDL) target goals. The evidence base would favor niacin therapy in combination with statin therapy to achieve the goals pertaining to LDL cholesterol and non-HDL cholesterol. The data about the combination of fibrate therapy with statin therapy are disappointing.

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