Management of cardiovascular risk in the light of current recommendations


Authors: Peter Sabaka
Authors‘ workplace: Klinika infektológie a geografickej medicíny LF UK, SZU a UNB, Nemocnica akad. L. Dérera, Bratislava
Published in: Forum Diab 2018; 7(1): 5-9
Category:

Overview

Presence of type 2 diabetes mellitus (T2DM) significantly increases risk of cardiovascular events and cardiovascular death. Lipoprotein metabolism disorders in patients with T2DM are significantly contributing to this risk. For a diabetic dyslipid­emia, high concentration of triacylglycerol (TAG) and low concentration of high density lipoprotein (HDL) is typical. On the level of lipoprotein subclasses, high concentration of small dense low-density lipoproteins (LDL) and very low-density lipoproteins and remnant particles are almost constant findings in patients with diabetes. The dyslipidemia in T2DM should treated by combination of non-pharmacologic and pharmacologic therapy. Mainstay of pharmacologic therapy are statins. If statin monotherapy is not sufficient to achieve target levels of LDL, combination therapy is recommended. There is sufficient evidence about effectivity of statin combination with ezetimibe or PCSK9 inhibitor. Fibrates are recommended only in selected patients like those with retinopathy or very high TAG levels

Key words:
diabetes mellitus type 2, dyslipidemia, lipoproteins

Received:
22. 12. 2017

Accepted:
31. 1. 2018


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Diabetology Endocrinology Internal medicine
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