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.
Jialal
Ishwarlal
I
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
Amess
William
W
Kaur
Manpreet
M
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