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The European Society of Cardiology

Treating dyslipidaemia in the patient with type 2 diabetes

D.J. Betteridge*

Department of Medicine, University College London Medical School, The Middlesex Hospital, London, UK

* Correspondence: Prof. D.J. Betteridge, Department of Medicine, University College London Medical School, The Middlesex Hospital, Mortimer Street, London W1N 8AA, UK. Tel.: +44-207-679-9444; fax: +44-207-679-9440
j.betteridge{at}ucl.ac.uk

Abstract

Cardiovascular disease (CVD) is a major cause of morbidity and mortality in patients with type 2 diabetes. Individuals with diabetes are at a much greater risk of developing CVD than those without diabetes, and have a much poorer outcome. For any given concentration of plasma cholesterol, the risk of CVD is approximately three times higher in subjects with diabetes, compared with those without the disease. The mechanisms underlying this increase in risk not only involve hyperglycaemia but also other major risk factors, such as dyslipidaemia and hypertension, which are potentially modifiable. The involvement of multiple risk factors in diabetes underlines the fact that it is a vascular disease, requiring total risk factor management. Diabetic dyslipidaemia is characterized by hypertriglyceridaemia, the accumulation of cholesterol-rich remnant particles, small dense low-density lipoprotein (LDL) and low high-density lipoprotein (HDL). Clinical trials have provided unequivocal evidence of the importance of lipid-lowering therapy in the secondary prevention of CVD in patients with diabetes. Lipid-lowering therapy is also beneficial in the primary prevention setting. Further information will become available from ongoing prospective studies in specific lower-risk diabetic populations.

Key Words: Diabetic dyslipidaemia • Hypertriglyceridaemia • Lipid-lowering therapy • Low-density lipoprotein • Type 2 diabetes


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