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Lipid Treatment in Diabetic Patients: from Guidelines to Clinical Practice

Introduction
Morbidity and mortality rate arising from atherosclerotic cardiovascular disease (ASCVD) in diabetic patients, in developing or even in develop countries are still high. There was study conducted at the Joslin Clinic, -the Diabetes Natural History Study-, followed for up to 25 years patients diagnosed between 1939 and 1959. Among men diagnosed between ages 30 and 49 years, there was no excess mortality until after age 50 years, in contrast with women, who had significant excess mortality from age 30 years and on. The median survival age was 66 years for men and 65 years for women, respectively, 5 and 12 years shorter than in the general population. Patients diagnosed between ages 50 and 69 years could expect median survival of 71 and 72 years, respectively -2 and 5 years shorter than the general population.
A question then comes out: “Why do people with diabetes die too soon?” The common conditions coexisting with type 2 diabetes mellitus (T2DM) such as hypertension and dyslipidemia are clear risk factors for ASCVD, and diabetes itself confers independent risk. Many studies have shown the efficacy of controlling individual cardiovascular risk factors in preventing or slowing the progression of ASCVD in people with diabetes. There are large benefits seen when multiple risk factors are addressed simultaneously. Type 2 diabetes patients have an increased prevalence of dyslipidemia, contributing to their high risk of ASCVD.
This paper will focus on the management of one part of ASCVD risk factors that is dyslipidemia in diabetes.