Diabetes Update 2017 – Lipide

Parhofer, K. G. (2017): Diabetes Update 2017 – Lipide. In: Diabetologe, Bd. 13, Nr. 5: S. 313-321

Abstract

Many patients with diabetes mellitus are characterized by changes in lipid metabolism. Typical dyslipoproteinemia (elevated triglycerides, low HDL cholesterol [HDL: high-density lipoproteins], small dense LDL particles [LDL: low-density lipoproteins]) is the most important link between diabetes mellitus and premature cardiovascular disease. Rigorous treatment of elevated lipids reduces cardiovascular morbidity and mortality. The primary goal is the reduction of LDL cholesterol. In diabetes patients and established cardiovascular disease or additional risk factors or end-organ damage, the LDL cholesterol level should be < 70 mg/dl (< 1.8 mmol/l) with a non-HDL cholesterol value < 100 mg/dl (< 2.6 mmol/l). In patients with diabetes but without the above mentioned characteristics, the LDL cholesterol value should be < 100 mg/dl (< 2.6 mmol/l) and the non-HDL cholesterol value < 130 mg/dl (< 3.4 mmol/l). To achieve these targets, statins, statins with ezetimibe, or a combination of statins with ezetimibe and proprotein convertase subtilisin-kexin type 9 (PCSK9) inhibitors should be sequentially used in addition to lifestyle modification and glucose control. LDL apheresis is available as a "last resort" form of therapy. Concerning the hypertriglyceridemia which is very often present, lifestyle modification and glucose control are the most important treatment modalities. In patients with very high risk, a combination with fibrates and/or omega aEuro3-fatty acids can be considered despite the lack of convincing outcome data. New medications for the treatment of dyslipoproteinemia are currently being developed but must be evaluated in outcome trials before they can be used in clinical practice.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 1860-9716
• Sprache: Deutsch