Article Contents ::
Dyslipidemia in diabetes Signs Management with Drugs for diabetic dyslipidemics
Dyslipidemia in diabetes
- Hypertriglyceridemia
- Reduced HDL cholesterol
- Small dense LDL particles:
- Highly atherogenic
- Easily glycated
- Susceptible to oxidation.
Management of Dyslipidemia in diabetes
- · Lipids should be aggressively treated
- · Hyperglycemia should be strictly managed Grave cardiovascular risk in dyslipidemic diabetics
Target lipid values in diabetics :
- · LDL < 100 mg/dl
- · HDL >40 mg/dl – in men
- · HDL >50 mg/dl – in women
- · Triglycerides < 150 mg/dl
–Treatment of Diabetic Dyslipidemia :
- · Lower LDL cholesterol
- · Raise HDL cholesterol
- · Decrease triglycerides
- · Dietary changes
- · Lifestyle modifications
Lifestyle changes in diabetics :
- · Smoking cessation
- · Control blood pressure
- · Weight loss
- · Exercises
- · Yoga
- · Meditation
- · Remove stress
- · Diet
- · Saturated fats and cholesterol in diet has a definite link with CAD
- · Dietary fat and cholesterol reduce myocardial perfusion by causing changes in platelet aggregation and diameter of coronary arteries
- · Increase in intake of monounsaturated fats
- · Increase intake of carbohydrates
- · Increase intake of fiber (whole foods)
- · Reduce saturated fats
- · Reduce cholesterol in diet.
- STRICT DIETARY REGIME CAN LOWER LDL >25 MG/ DL
- Strict glycemic control i.e. control of blood sugar lev–
- · Will lower triglycerides
- · Will raise HDL
Drugs for diabetic dyslipidemics :
- · HMG Co-A reductase inhibitors
- · Fibric acid derivatives
- · Nicotinic acid
- · Bile acid sequestrants
- Fish oil
- Cholesterol absorption inhibitors
- All individuals >40 yrs of age with diabetes and total cholesterol >135 mg/dl may benefit from HMG Co-A reductase inhibitors.