J Korean Diabetes.  2014 Jun;15(2):61-64. 10.4093/jkd.2014.15.2.61.

Treatment Guideline for Dyslipidemia in Diabetes Mellitus

Affiliations
  • 1Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Bucheon, Korea. dream4hope@naver.com

Abstract

The recently published 2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults published by the American Heart Association (AHA) and American College of Cardiology (ACC) changes the treatment paradigm for high cholesterol. Based on a systematic review of randomized controlled clinical trials (RCTs), the new guideline no longer targets LDL cholesterol (LDL-C) level but focuses on treating cholesterol to reduce atherosclerotic cardiovascular disease (ASCVD) risk. Only data from RCTs of cholesterol-lowering drug therapies with cardiovascular outcomes or meta-analyses of these RCTs were considered. In Type 2 diabetes in those 40~75 years of age with risk factors, the potential benefits of LDL-C reduction with a high-intensity statin are substantial. Because those with diabetes often have a lower LDL-C level than those without diabetes, "goal"-directed therapy often encourages use of a lower statin dose than is supported by the RCTs, and non-statin drugs may be included to address low HDL-C or high triglycerides, for which there is little RCT evidence of an ASCVD event reduction.

Keyword

Cholesterol; Guideline; Type 2 diabetes mellitus

MeSH Terms

Adult
American Heart Association
Cardiology
Cardiovascular Diseases
Cholesterol
Cholesterol, LDL
Diabetes Mellitus*
Diabetes Mellitus, Type 2
Drug Therapy
Dyslipidemias*
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Risk Factors
Triglycerides
Cholesterol
Cholesterol, LDL
Triglycerides

Figure

  • Fig. 1. Major recommendations for statin therapy for atherosclerotic cardiovascular disease (ASCVD) prevention. Adapted from Stone NJ, et al. J Am Coll Cardiol 2013[1].


Reference

References

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