title: Beyond statin therapy: a review of the management of residual risk in diabetes mellitus.
abstract: Total cholesterol and low-density lipoprotein (LDL) cholesterol exhibit an independent, strong, continuous correlation with cardiovascular events. The effectiveness of hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins) in the treatment and prevention of atherosclerosis is well-established. However, despite the lowering of LDL targets and the increased use of statins, patients with type 2 diabetes mellitus (DM) continue to experience a higher proportion of adverse coronary artery disease events. This is as a result of an atherogenic dyslipidaemia, characterized by low levels of high-density lipoprotein and elevated plasma triglyceride concentrations, often with high levels of cholesterol-rich remnant particles. This article will review dyslipidaemia and its role in DM, and will discuss available treatment modalities that address residual cardiovascular risk in this disease.
authors.affiliation: Department of Endocrinology, St Columcille's Hospital, Loughlinstown, Co. Dublin, Ireland.
authors.forename: Eoin P
authors.initials: EP
authors.lastname: Judge
authors.forename: D
authors.initials: D
authors.lastname: Phelan
authors.forename: Donal
authors.initials: D
authors.lastname: O'Shea
mesh_terms: D050197:Atherosclerosis / Q000517:prevention & control*; D002995:Clofibric Acid / Q000627:therapeutic use*; D048909:Diabetes Complications / Q000188:drug therapy*; D003920:Diabetes Mellitus / Q000188:drug therapy; D004359:Drug Therapy, Combination; D050171:Dyslipidemias / Q000150:complications / Q000188:drug therapy*; D015525:Fatty Acids, Omega-3 / Q000627:therapeutic use*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D009525:Niacin / Q000627:therapeutic use*
chemical_list: D015525:Fatty Acids, Omega-3; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D009525:Niacin; D002995:Clofibric Acid
references.citation: Diabetes Care. 2009 Mar;32(3):493-8
references.pmid: 18984774
references.citation: J Intern Med. 2006 Jun;259(6):583-91
references.pmid: 16704559
references.citation: Invest Ophthalmol Vis Sci. 2004 Mar;45(3):910-8
references.pmid: 14985310
references.citation: JAMA. 1975 Jan 27;231(4):360-81
references.pmid: 1088963
references.citation: N Engl J Med. 2005 Jan 27;352(4):341-50
references.pmid: 15673800
references.citation: Lancet. 2005 Nov 26;366(9500):1849-61
references.pmid: 16310551
references.citation: Am J Cardiol. 2008 May 15;101(10):1428-36
references.pmid: 18471454
references.citation: Lancet. 2007 Mar 31;369(9567):1090-8
references.pmid: 17398308
references.citation: Lancet. 2001 Dec 15;358(9298):2026-33
references.pmid: 11755609
references.citation: Diabetes Care. 2006 Jan;29(1):78-82
references.pmid: 16373900
references.citation: Am J Cardiol. 2005 Feb 15;95(4):462-8
references.pmid: 15695129
references.citation: Diabet Med. 2002 Nov;19(11):900-9
references.pmid: 12421426
references.citation: Diabetes. 2006 Jun;55(6):1832-9
references.pmid: 16731850
references.citation: Am J Cardiol. 2007 Dec 15;100(12):1759-66
references.pmid: 18082522
references.citation: Diabetes Care. 2005 Aug;28(8):1916-21
references.pmid: 16043732
references.citation: Int J Obes (Lond). 2008 May;32 Suppl 2:S11-6
references.pmid: 18469834
references.citation: Atherosclerosis. 2006 Nov;189(1):19-30
references.pmid: 16530201
references.citation: N Engl J Med. 2008 Jul 17;359(3):229-41
references.pmid: 18635428
references.citation: Am J Cardiol. 2008 Apr 17;101(8A):20B-26B
references.pmid: 18375237
references.citation: Clin Ther. 2007 Jul;29(7):1354-67
references.pmid: 17825687
references.citation: Diab Vasc Dis Res. 2008 Nov;5(4):319-35
references.pmid: 18958843
references.citation: Am J Cardiol. 2007 Mar 19;99(6A):22C-31C
references.pmid: 17368274
references.citation: N Engl J Med. 1998 Jul 23;339(4):229-34
references.pmid: 9673301
references.citation: Lancet. 1998 Sep 12;352(9131):854-65
references.pmid: 9742977
references.citation: J Diabetes Complications. 2005 Jan-Feb;19(1):18-25
references.pmid: 15642486
references.citation: Am J Med. 2009 Oct;122(10):962.e1-8
references.pmid: 19698935
references.citation: Am J Cardiol. 2005 Jan 1;95(1):120-2
references.pmid: 15619408
references.citation: Lancet. 2008 Jan 12;371(9607):117-25
references.pmid: 18191683