title: Recent advances in the treatment of atherogenic dyslipidemia in type 2 diabetes mellitus.
abstract: Despite best treatment efforts reducing low-density lipoprotein cholesterol, a substantial number of type 2 diabetes mellitus patients still experience progression of cardiovascular risk. Even with intensification of statin therapy, a substantial residual cardiovascular risk remains and atherogenic dyslipidemia is an important driver of this so-called residual risk. Besides statin therapy, new strategies evaluate the role of intensive combination lipid treatment for the entire type 2 diabetic population. The results from the ACCORD (Action to Control Cardiovascular Risk in Diabetes) Lipid trial suggest that there is a lipid-related modifiable component to cardiovascular residual risk in statin-treated type 2 diabetic patients, and that further research should address patients with triglycerides above 204 mg/dl and high-density lipoprotein cholesterol below 34 mg/dl. Based on their respective lipid-modifying activity, the combination of a fibrate and statin is a logical approach to improving achievement of lipid targets in statin-treated patients with a glomerular filtration rate of >60 ml/min/1.73 m(2) and with residual atherogenic dyslipidemia. The link between dyslipidemia treatment and diabetic retinopathy, nephropathy and neuropathy is an emerging new field and microvascular complications are targets for new treatments.
authors.affiliation: Department of Medicine, Division of Nephrology, University of Würzburg, Würzburg, Germany. wanner_c@medizin.uni-wuerzburg.de
authors.forename: Christoph
authors.initials: C
authors.lastname: Wanner
authors.forename: Vera
authors.initials: V
authors.lastname: Krane
mesh_terms: D050197:Atherosclerosis / Q000209:etiology* / Q000517:prevention & control; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000188:drug therapy; D004359:Drug Therapy, Combination; D050171:Dyslipidemias / Q000150:complications*; D058607:Fibric Acids / Q000627:therapeutic use; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D000960:Hypolipidemic Agents / Q000627:therapeutic use*
chemical_list: D058607:Fibric Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D000960:Hypolipidemic Agents