The authors review the association between
diabetes mellitus (DM) and aberrations of lipid metabolism related to DM, diabetic
dyslipidemia (DD). DM is considered as a major health burden worldwide and one of the most important modifiable
cardiovascular disease (CVD) risk factors. This applies to both the developed and the developing countries, especially the latter. While patients with type 1 DM, 10% of all DM cases, usually do not have
dyslipidemia, DD is frequent among patients with type 2 DM (T2DM) (prevalence > 75%) and is mainly a mixed
dyslipidemia [increase in
triglycerides (TGs), low
high-density lipoprotein cholesterol (HDL-C), and small-dense (atherogenic),
low-density lipoprotein cholesterol (
LDL-C) particles]. The components of DD, which is characterized by quantitative (mentioned above), qualitative, and kinetic abnormalities all contributing to CVD risk, are mostly related to
insulin resistance.
Statins,
ezetimibe, and
PCSK9 inhibitors can be used in monotherapy or consecutively in combinations if needed.
Statins compose the main drug. For the residual CVD risk after
statin treatment, the use of
statin-
fibrate combinations is indicated only in patients with mixed
dyslipidemia. In conclusion, DD is a major health problem worldwide. It is a significant CVD risk factor and should be treated according to current guidelines. The means today exist to normalize all quantitative, qualitative, and kinetic aberrations of DD, thereby reducing CVD risk.