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.