Management of hypertriglyceridemia in the diabetic patient.
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.
VA 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. ishwarlal.jialal@ucdmc.ucdavis.edu
Ishwarlal
I
Jialal
William
W
Amess
Manpreet
M
Kaur
D002995:Clofibric Acid / Q000627:therapeutic use; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D015228:Hypertriglyceridemia / Q000150:complications* / Q000188:drug therapy* / Q000378:metabolism; D000960:Hypolipidemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000627:therapeutic use; D009525:Niacin / Q000627:therapeutic use*; D014280:Triglycerides / Q000378:metabolism
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D000960:Hypolipidemic Agents; D007328:Insulin; D014280:Triglycerides; D009525:Niacin; D002995:Clofibric Acid