Implications of cardiovascular risk in patients with type 2 diabetes who have abnormal lipid profiles: is lower enough?
Article first published online: 25 DEC 2001
Diabetes, Obesity and Metabolism
Volume 2, Issue 5, pages 263–270, October 2000
How to Cite
Garber, A. J. (2000), Implications of cardiovascular risk in patients with type 2 diabetes who have abnormal lipid profiles: is lower enough?. Diabetes, Obesity and Metabolism, 2: 263–270. doi: 10.1046/j.1463-1326.2000.00100.x
- Issue published online: 25 DEC 2001
- Article first published online: 25 DEC 2001
- Received 10 March 2000; accepted 13 March 2000
Patients with type 2 diabetes are at high risk for coronary heart disease (CHD); frequently, these patients have abnormal lipid profiles, placing them at even greater risk. A syndrome of insulin resistance, hyperinsulinaemia, hypertension, and high levels of fibrinogen and plasminogen activator inhibitor contributes to cardiovascular risk, which is not sufficiently decreased by glycaemic control alone. In several large interventional trials, CHD risk in patients with diabetes was substantially reduced by aggressive lipid-lowering therapy. In patients with diabetes, CHD, low high-density lipoprotein levels, and normal low-density lipoprotein levels, gemfibrozil reduced fatal and non-fatal CHD events. For lipid-lowering in patients with diabetes and CHD, pravastatin and simvastatin are the only HMG-CoA reductase inhibitors shown to reduce fatal and non-fatal CHD events. Of these, pravastatin has less potential for drug–drug interactions and may be safer to use, particularly for combination therapy with fibric acid derivatives, as may now be important for CHD prevention in mixed dyslipidaemias.