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Curr Cardiol Rep. 2019 Nov 22;21(11):147. doi: 10.1007/s11886-019-1246-1.

Management of Lipid Abnormalities in Patients with Diabetes.

Author information

1
The Institute of Cardiovascular and Medical Sciences, University of Glasgow, BHF Glasgow Cardiovascular Research Centre, 126 University Place, Glasgow, G12 8TA, UK.
2
The Institute of Cardiovascular and Medical Sciences, University of Glasgow, BHF Glasgow Cardiovascular Research Centre, 126 University Place, Glasgow, G12 8TA, UK. naveed.sattar@glasgow.ac.uk.

Abstract

PURPOSE OF REVIEW:

To describe lipid abnormalities in diabetes, when they occur and the evidence base for lipid management with established and new drugs to prevent diabetes complications. We also discuss how to manage statin intolerance.

RECENT FINDINGS:

Statins remain first-line therapy in patients with diabetes, though newer therapies to reduce LDL-C have emerged, including ezetimibe as an add-on therapy to statins, and injectable PCSK9 inhibitors, both of which are safe and effective in diabetes. Emerging evidence suggests a need to consider lipid-lowering therapies more often in younger patients with both type 1 and type 2 diabetes. Statins remain the cornerstone of lipid management in diabetes but other options are increasing. There is also now evidence for better managing apparent statin intolerance. Notably, younger patients lose the most life years from their diabetes, an observation that future guidelines need to consider.

KEYWORDS:

Dyslipidemia; Ezetimibe; PCSK9 inhibitors; Statins; Type 1 diabetes; Type 2 diabetes

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