Abstract
Diabetic dyslipidaemia is among secondary dyslipoproteinaemias due to the fact that lipid metabolism abnormalities are a part of the complex metabolic disorder in diabetes. Diabetic dyslipidaemia significantly contributes to an increased risk of developing atherosclerosis and cardiovascular mortality in people with diabetes.
The results of studies and the meta-analyses performed have provided more accurate data on the efficacy and safety of individual drug groups in terms of preventing cardiovascular events in patients with diabetes. The favourable results of treatment with statins in the population of patients with DM (a proportional reduction in all-cause mortality by 9% and of the risk of cardiovascular events by 21 % while reducing LDL cholesterol by 1 mmol/l independently on other parameters) have strengthened their dominant position in the guidelines of professional societies.
There has been a continuing debate over the form of combination therapy and the role of other pharmaceuticals, particularly fibrates and nicotinic acid. These drugs combined with statins failed to have the expected cardiovascular protective effect in the studies.
The results of analyses suggest that fibrates may only be beneficial in those with a certain metabolic profile (a triglyceride level > 2.3 mmol/l as well as HDL < 0.9 mmol/l) and not in persons with diabetes in general. In order to improve the strategy of treatment for diabetic dyslipidaemia, it will be necessary to know the results of ongoing studies of niacin, ezetimibe and/or novel cholesteryl ester transfer protein inhibitors that would define the efficacy of these agents in reducing residual cardiovascular risk following an effective treatment with statins.