[Statins in diabetic hyperlipidemia]

Abstract

Several placebo-controlled prospective multicenter trials showed convincing evidence that cholesterol lowering with statins reduced mortality due to coronary heart disease. Subgroup analyses of diabetic patients demonstrated significant reduction of coronary death rates in diabetics even more pronounced than that observed with the nondiabetic population. In some studies significant reduction of strokes was also achieved by lipid lowering. In one diabetic subgroup stroke reduction nearly reached significance despite low number of patients. New studies are currently in progress investigating the effect of lipid lowering specifically for diabetic patients. Some of these studies are designed to evaluate the effects of drugs acting primarily on triglycerides, such as the fibrates, or showing both, triglyceride and cholesterol reduction, like some newer statins, especially atorvastatin. The dyslipidemia encountered most frequently with diabetics is an increase of triglycerides and low HDL-cholesterol. Because of the high cardiovascular risk of diabetics the target levels of LDL-cholesterol in secondary and primary prevention should not exceed 100 mg/dl as in secondary prophylaxis in patients without diabetes.