Management of dyslipoproteinemia in the presence of diabetes mellitus

Authors: Katarína Rašlová
Authors‘ workplace: Koordinačné centrum pre familiárne hyperlipoproteinémie, Slovenská zdravotnícka univerzita, Bratislava
Published in: AtheroRev 2017; 2(2): 122-124
Category: reviews


Diabetes mellitus is a group of metabolic diseases that are characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both. Insulin plays an important role in the regulation of metabolism of plasma lipoproteins and therefore a high incidence of dyslipoproteinemia in patients with diabetes is not surprising. Dyslipoproteinemia and diabetes represent two major independent risk factors for atherosclerosis, the parallel impacts of which exponentially increase the risk for cardiovascular events and death. Clinical studies have shown that treatment of dyslipidemia in diabetic patients plays an important part in the prevention of cardiovascular events and death.

Key words:
type 2 diabetes mellitus, atherogenic dyslipidemia, statins, fibrates


1. Ray KK, Seshasai SR, Wijesuriya S et al. Effect of intensive control of glucose on cardiovascular outcomes and death in patients with diabetes mellitus: a meta-analysis of randomised controlled trials. Lancet 2009; 373(9677): 1765–1772. Dostupné z DOI: <–6736(09)60697–8>.

2. Fontbonne A, Eschewege E, Cambien F et al. Hypertriglyceridemia as risk factor of coronary heart disease mortality in subjects with impaired glucose tolerance and diabetes. Results from the 11-year follow-up of the Paris prospective study. Diabetologia 1989; 32(5): 300–304.

3. Haffner SM, Mykkänen L, Valdez RA et al. LDL size and subclass pattern in a biethnic population. Arterioscler Thromb 1993; 13(11): 1623–1630.

4. Krowlewski AS, Kosinski EJ, Warram JH et al. Magnitude and determinants of coronary heart disease in juvenile onset insulin dependent diabetes mellitus. Am J Cardiol 1987; 59(8): 750–755.

5. Barret-Connor E, Phillipi T, Khaw KT. Lipoproteins as predictors of ischemic heart disease in non insulin dependent diabetic men. Am J Prev Med 1987; 3(4): 206–210.

6. Barret-Connor E, Wingard DL. Sex differnetial in ischemic heart disease mortality in diabetics: a prospective population-based study. Am J Epidemiol 1983; 118(4): 489–496.

7. Rubins HB., Robins SJ, Collins D et al. For the Veterans Affairs – High density lipoprotein Intervention Trial study group. Diabetes, plasma insulin and cardiovascular disease. Subgroup analysis from the VA-HIT. Arch Intern Med 2002; 162(22): 2597–2604.

8. [Diabetes Atherosclerosis Intervention Study Investigators]. Effect of fenofibrate on porgression of coronary artery disease in type 2 diabetes: the Diabetes Atherosclerosis Intervention Study, a randomised study. Lancet 2001, 357(9260): 905–910. Erratum in Lancet 2001; 357(9271): 1890.

9. Collins R, Armitage J, Parish S et al. [Heart Protection Study Collaborative Group]. MRC/BHF Heart Protection Study of cholesterol lowering with simvastatin in 5963 peaople with diabetes: a randomised placebo controlled trial. Lancet 2003; 361(9374): 2005–2016.

10. Taskinen M-R. Diabetic dyslipidemia: from basic research to clinical practice. Diabetologia 2003; 46(6): 733–749.

11. Frohlich J, Dobiásová M. Fractional esterification rate of cholesterol and ratio of triglycerides to HDL-cholesterol are powerful predictors of positive findings on coronary angiography. Clin Chem 2003; 49(11): 1873–1880.

12. Jacobson TA, Ito MK, Maki KC et al. National Lipid Association recommendations for patient-centered management of dyslipidemia. J Clin Lipidol 2015;9(2):129–169. Dostupné z DOI: <>.

13. Haffner SM, Alexander CM, Cook TJ et al. Reduced coronary events in simvastatin-treated patients with coronary heart disease and diabetes or impaired fasting glucose levels. Arch Intern Med 1999; 159(22): 2661–2667.

14. Goldberg RB, Mellies MJ, Sacks FM et al. [Care Investigators]. Cardiovascular events and their reduction with pravastatin in diabetic and glucose-intolerant myocardial infarction survivors with average cholesterol levels. Subgroup analyses in the Cholesterol And Recurrent Events (CARE) Trial. Circulation 1998; 98(23): 2513–2519.

15. Keech A, Colquhoun D, Best J et al. Secondary prevention of cardiovascular events with long-term pravastatin in patients with diabetes or impaired fasting glucose. Results from the LIPID trial. Diabetes Care 2003; 26(10): 2713–2721.

16. Serruys PWJC, de Feyter P, Macaya C et al. [Lescol Intervention Prevention Study (LIPS) Investigators]. Fluvastatin for prevention of cardiac events following successful first percutaneous coronary intervention. A randomized controlled trial. J Am Med Assoc 2002; 287(24): 3215–3222.

17. Colhoun HM, Betteridge DJ, Durrington PN et al. [CARDS investigators]. Primary prevention of cardiovascular disease with atorvastatin in type 2 diabetes in the Collaborative Atorvastatin Diabetes Study (CARDS): multicentre randomised placebo-controlled trial. Lancet 2004; 364(9435) :685–696.

18. Keech A, Simes RJ, Barter P et al. [FIELD Study Investigators]. Effects of long-term fenofibrate therapy on cardiovascular events in 9795 people with type 2 diabetes mellitus (the FIELD study): randomised controlled trial. Lancet 2005; 366(9500): 1849–1861. Erratum in Correction to the FIELD study report. Lancet 2006; 368(9545): 1420.

19. Tenenbaum A, Motro M, Fisman EZ et al. Bezafibrate for the secondary prevention of myocardial infarction in patients with metabolic syndrome. Arch Intern Med 2005; 165(10): 1154–1160.

20. Ginsberg HN, Elam MB, Lovato LC et al. [ACCORD Study Group]. Effects of combination lipid therapy in type 2 diabetes mellitus. N Engl J Med 2010; 362(17): 1563–1574. Dostupné z DOI: <>.Erratum in N Engl J Med 2010; 362(18): 1748.

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