title: Is combination therapy an effective way of reaching lipid goals in type 2 diabetes mellitus?
abstract: Type 2 diabetes mellitus is associated with a specific pattern of plasma lipid and lipoprotein abnormalities. Lipid goals are often not attained with statins alone, and combination lipid-lowering strategies may need to be considered in an attempt to further reduce the residual cardiovascular risk. Combination therapy utilizes various classes of lipid-lowering medications with different mechanisms of action and different effects on lipid levels. Clinical trial data support the efficacy of combining statins with fibrates, niacin, ezetimibe (cholesterol absorption inhibitor) and colesevelam (bile acid sequestrant) with the caveat that there are insufficient clinical trial data to show a further robust benefit on cardiovascular outcomes. Of the different combination therapy options to potentiate low-density lipoprotein cholesterol lowering in combination with a statin, colesevelam provides additional beneficial effects by further reducing hemoglobin A1c levels in Type 2 diabetes mellitus.
authors.affiliation: Metabolic Institute of America, 18372 Clark Street, Suite #212, Tarzana, CA 91356, USA. yhandelsman@pacbell.net
authors.forename: Yehuda
authors.initials: Y
authors.lastname: Handelsman
authors.forename: Vivian
authors.initials: V
authors.lastname: Fonseca
authors.forename: Julio
authors.initials: J
authors.lastname: Rosenstock
mesh_terms: D000818:Animals; D000924:Anticholesteremic Agents / Q000008:administration & dosage; D002318:Cardiovascular Diseases / Q000097:blood / Q000188:drug therapy; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D002986:Clinical Trials as Topic / Q000379:methods; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D006040:Goals; D006801:Humans; D000960:Hypolipidemic Agents / Q000008:administration & dosage; D050356:Lipid Metabolism / Q000187:drug effects* / Q000502:physiology; D008077:Lipoproteins, LDL / Q000097:blood; D016896:Treatment Outcome
chemical_list: D000924:Anticholesteremic Agents; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D000960:Hypolipidemic Agents; D008077:Lipoproteins, LDL