Management of diabetic dyslipidemia in Indians: Expert consensus statement from the Lipid Association of India

Raman Puri¹, Vimal Mehta², P Barton Duell³, S K Wangnoo⁴, Ashu Rastogi⁵, V Mohan⁶, Abdul Hamid Zargar⁷, Sanjay Kalra⁸, Abhay Kumar Sahoo⁹, S S Iyengar¹⁰, Jamal Yusuf², Saibal Mukhopadhyay¹¹, Mani Kant Singla¹², Altamash Shaikh¹³, Sunil Kohli¹⁴, Sandeep Mathur¹⁵, Sachin Jain¹⁶, S N Narasingan¹⁷, Vipul Gupta¹⁸, Rajeev Agarwala¹⁹, Vinod Mittal²⁰, Amit Varma²¹, Jayant Kumar Panda²², Sadanand Shetty²³, Madhur Yadav²⁴, A Muruganathan²⁵, Pradeep Dabla²⁶, K K Pareek²⁷, P C Manoria²⁸, Rashmi Nanda²⁹, G B Sattur³⁰, A K Pancholia³¹, Nathan D Wong³²

Affiliations

¹ Senior Consultant Cardiologist, Indraprastha Apollo Hospitals, New Delhi, India(Drs Puri). Electronic address: lipidaoi@gmail.com.
² Director-Professor, Department of Cardiology, G.B. Pant Institute of Postgraduate Medical Education and Research, New Delhi, India(Drs Mehta and Yusuf).
³ Professor of Medicine, Knight Cardiovascular Institute and Division of Endocrinology, Diabetes and Clinical Nutrition, Oregon Health & Science University, Portland, OR, USA (Drs Duell).
⁴ Sr. Consultant Endocrinologist & Diabetologist, Indraprastha Apollo Hospitals, New Delhi, India (Drs Wangnoo).
⁵ Assistant Professor, Department of Endocrinology & Metabolism, PGIMER Chandigarh, Punjab, India (Drs Rastogi).
⁶ Director Madras Diabetic Research Foundation & Chairman & chief Diabetologist, Dr Mohan Diabetes specialities Centre, Chennai, Tamil Nadu, India (Drs Mohan).
⁷ Medical Director, Center for Diabetes & Endocrine Care, National Highway, Gulshan Nagar, Srinagar, J&K, India (Drs Zargar).
⁸ Consultant, Department of Endocrinology, Bharti Hospital, Karnal, Haryana, India (Drs Kalra).
⁹ Associate Professor in Endocrinology at IMS and SUM Hospital, Bhubaneshwar, India (Drs Sahoo).
¹⁰ Sr. Consultant and Head, Department of Cardiology, Manipal Hospital, Bangalore, Karnataka, India (Drs Iyengar).
¹¹ Director-Professor and Head, Department of Cardiology, G.B. Pant Institute of Postgraduate Medical Education and Research, New Delhi, India (Drs Mukhopadhyay).
¹² Director, MKS Endocrinologist, Ludhiana, Punjab, India (Drs Singla).
¹³ Sr. Consultant, Endocrinology, Saifee Hospital, Mumbai, Maharashtra, India (Drs Shaikh).
¹⁴ Professor and Head Department of Medicine, Hamdard Institute of Medical Sciences, New Delhi, India (Drs Kohli).
¹⁵ Professor and Head of Department of Endocrinology, SMS Medical College and Hospital, Jaipur, Rajasthan, India (Drs Mathur).
¹⁶ Ex. Director Professor Lady Harding Medical College, New Delhi, India (Drs Jain).
¹⁷ Former Adjunct Professor of medicine, Dr MGR Medical University, and Managing Director, SNN Specialities Clinic, Chennai, Tamil Nadu, India (Drs Narasingan).
¹⁸ Medical Director, Gupta Ultrasound & Heart care Centre, New Delhi, India (Drs Gupta).
¹⁹ Sr. Consultant Cardiologist, Jaswant Rai Speciality Hospital, Meerut, Uttar Pradesh, India (Drs Agarwala).
²⁰ Sr. Consultant Diabetologist & Head, Centre for Diabetes & Metabolic disease, Delhi Heart & Lung Institute, Delhi, India (Drs Mittal).
²¹ Professor & Head Department of Medicine, SGRR Institute of medical and health Sciences, Dehradun, Uttarakhand, India (Drs Varma).
²² Professor & Head, PG Department of Internal Medicine, SCB Medical College, Cuttack, Odisha, India (Drs Panda).
²³ Head, Department of Cardiology, K.J Somaiya Super Speciality Institute, Sion (East), Mumbai, Maharashtra, India (Drs Shetty).
²⁴ Director-Professor of Medicine, Lady Harding Medical College, New Delhi, India (Drs Yadav).
²⁵ Sr. Consultant Internal Medicine, AG Hospital, Tirupur, Tamil Nadu, India (Drs Muruganathan).
²⁶ Professor of Biochemistry, G.B. Pant Institute of Postgraduate Medical Education and Research, New Delhi, India (Drs Dabla).
²⁷ Head, Department of Medicine, S. N. Pareek Hospital, Dadabari, Kota, Rajasthan, India (Drs Pareek).
²⁸ Director, Heart and critical Care Hospital, Bhopal, Madhya Pradesh, India (Drs Manoria).
²⁹ Consultant Physician, Cardiac Care Centre, South Extension, New Delhi, India (Drs Nanda).
³⁰ Sr. Consultant Physician and Diabetologist, Sattur Medical Care, Hubli, Karnataka, India (Drs Sattur).
³¹ Head of Department, Medicine & Preventive Cardiology, Arihant Hospital & RC, Indore, Madhya Pradesh, India (Drs Pancholia).
³² Professor and Director, Heart Disease Prevention Program, Division of Cardiology, University of California Irvine, USA (Drs Wong).

PMID: 36577628
DOI: 10.1016/j.jacl.2022.11.002

Management of diabetic dyslipidemia in Indians: Expert consensus statement from the Lipid Association of India

Raman Puri et al. J Clin Lipidol. 2023 Mar-Apr.

. 2023 Mar-Apr;17(2):e1-e14.

doi: 10.1016/j.jacl.2022.11.002. Epub 2022 Nov 23.

Authors

Affiliations

¹ Senior Consultant Cardiologist, Indraprastha Apollo Hospitals, New Delhi, India(Drs Puri). Electronic address: lipidaoi@gmail.com.
² Director-Professor, Department of Cardiology, G.B. Pant Institute of Postgraduate Medical Education and Research, New Delhi, India(Drs Mehta and Yusuf).
³ Professor of Medicine, Knight Cardiovascular Institute and Division of Endocrinology, Diabetes and Clinical Nutrition, Oregon Health & Science University, Portland, OR, USA (Drs Duell).
⁴ Sr. Consultant Endocrinologist & Diabetologist, Indraprastha Apollo Hospitals, New Delhi, India (Drs Wangnoo).
⁵ Assistant Professor, Department of Endocrinology & Metabolism, PGIMER Chandigarh, Punjab, India (Drs Rastogi).
⁶ Director Madras Diabetic Research Foundation & Chairman & chief Diabetologist, Dr Mohan Diabetes specialities Centre, Chennai, Tamil Nadu, India (Drs Mohan).
⁷ Medical Director, Center for Diabetes & Endocrine Care, National Highway, Gulshan Nagar, Srinagar, J&K, India (Drs Zargar).
⁸ Consultant, Department of Endocrinology, Bharti Hospital, Karnal, Haryana, India (Drs Kalra).
⁹ Associate Professor in Endocrinology at IMS and SUM Hospital, Bhubaneshwar, India (Drs Sahoo).
¹⁰ Sr. Consultant and Head, Department of Cardiology, Manipal Hospital, Bangalore, Karnataka, India (Drs Iyengar).
¹¹ Director-Professor and Head, Department of Cardiology, G.B. Pant Institute of Postgraduate Medical Education and Research, New Delhi, India (Drs Mukhopadhyay).
¹² Director, MKS Endocrinologist, Ludhiana, Punjab, India (Drs Singla).
¹³ Sr. Consultant, Endocrinology, Saifee Hospital, Mumbai, Maharashtra, India (Drs Shaikh).
¹⁴ Professor and Head Department of Medicine, Hamdard Institute of Medical Sciences, New Delhi, India (Drs Kohli).
¹⁵ Professor and Head of Department of Endocrinology, SMS Medical College and Hospital, Jaipur, Rajasthan, India (Drs Mathur).
¹⁶ Ex. Director Professor Lady Harding Medical College, New Delhi, India (Drs Jain).
¹⁷ Former Adjunct Professor of medicine, Dr MGR Medical University, and Managing Director, SNN Specialities Clinic, Chennai, Tamil Nadu, India (Drs Narasingan).
¹⁸ Medical Director, Gupta Ultrasound & Heart care Centre, New Delhi, India (Drs Gupta).
¹⁹ Sr. Consultant Cardiologist, Jaswant Rai Speciality Hospital, Meerut, Uttar Pradesh, India (Drs Agarwala).
²⁰ Sr. Consultant Diabetologist & Head, Centre for Diabetes & Metabolic disease, Delhi Heart & Lung Institute, Delhi, India (Drs Mittal).
²¹ Professor & Head Department of Medicine, SGRR Institute of medical and health Sciences, Dehradun, Uttarakhand, India (Drs Varma).
²² Professor & Head, PG Department of Internal Medicine, SCB Medical College, Cuttack, Odisha, India (Drs Panda).
²³ Head, Department of Cardiology, K.J Somaiya Super Speciality Institute, Sion (East), Mumbai, Maharashtra, India (Drs Shetty).
²⁴ Director-Professor of Medicine, Lady Harding Medical College, New Delhi, India (Drs Yadav).
²⁵ Sr. Consultant Internal Medicine, AG Hospital, Tirupur, Tamil Nadu, India (Drs Muruganathan).
²⁶ Professor of Biochemistry, G.B. Pant Institute of Postgraduate Medical Education and Research, New Delhi, India (Drs Dabla).
²⁷ Head, Department of Medicine, S. N. Pareek Hospital, Dadabari, Kota, Rajasthan, India (Drs Pareek).
²⁸ Director, Heart and critical Care Hospital, Bhopal, Madhya Pradesh, India (Drs Manoria).
²⁹ Consultant Physician, Cardiac Care Centre, South Extension, New Delhi, India (Drs Nanda).
³⁰ Sr. Consultant Physician and Diabetologist, Sattur Medical Care, Hubli, Karnataka, India (Drs Sattur).
³¹ Head of Department, Medicine & Preventive Cardiology, Arihant Hospital & RC, Indore, Madhya Pradesh, India (Drs Pancholia).
³² Professor and Director, Heart Disease Prevention Program, Division of Cardiology, University of California Irvine, USA (Drs Wong).

PMID: 36577628
DOI: 10.1016/j.jacl.2022.11.002

Abstract

In 2021 an estimated 74 million individuals had diabetes in India, almost all type 2 diabetes. More than half of patients with diabetes are estimated to be undiagnosed and more 90% have dyslipidemia that is associated with accelerated development of atherosclerotic cardiovascular disease (ASCVD). Patients of Indian descent with diabetes have multiple features that distinguish them from patients with diabetes in Western populations. These include characteristics such as earlier age of onset, higher frequency of features of the metabolic syndrome, more prevalent risk factors for ASCVD, and more aggressive course of ASCVD complications. In light of the unique features of diabetes and diabetic dyslipidemia in individuals of Indian descent, the Lipid Association of India developed this expert consensus statement to provide guidance for management of diabetic dyslipidemia in this very high risk population. The recommendations contained herein are the outgrowth of a series of 165 webinars conducted by the Lipid Association of India across the country from May 2020 to July 2021, involving 155 experts in endocrinology and cardiology and an additional 2880 physicians.

Keywords: Cardiovascular prevention; Diabetes; Diabetic dyslipidemia; Expert consensus; Treatment.

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Conflict of interest statement

Conflict of interest Raman Puri: Boehringer Ingelheim, Novartis Vimal Mehta: Institutional research grants from Amgen, AstraZeneca, Boehringer Ingelheim, Eli Lilly, LIB Therapeutics, Novo Nordisk, Torrent P Barton Duell: Advisory activities: Akcea/Ionis, Esperion, Novo Nordisk, Regeneron, Kaneka. Institutional grants: Regeneron, Regenxbio, Retrophin/Travere V Mohan: Research or educational grants from Abbott, AstraZeneca, Boehringer Ingelheim, Dr. Reddy's Lab, Johnson and Johnson, Lifescan, MSD, Novartis, Novo Nordisk, Roche Diabetes Care India Private Ltd, Sanofi-Aventis, USV, other Indian pharmaceutical companies S. S. Iyengar: Dr. Reddy's Lab, Amgen, Emcure, Glenmark, Boehringer Ingelheim, Pfizer, Novartis Vinod Mittal: Boehringer Ingelheim, USV, Cipla, Intas, Emcure, MacLeods S N Narasingan: USV, Novo Nordisk, Eris, Glenmark, Torrent, Boehringer Ingelheim J.B. Chemicals and Pharmaceuticals Nathan D. Wong: Amgen, Amarin, Novartis, Esperion SK Wangnoo: Sanofi- Aventis, Nova Nordisk, Boehringer Ingelheim, Astra Zeneca The other authors report no conflict of interest.

Comment in

Management of diabetic dyslipidemia in South Asian patients: The need for individualized treatment guidelines.
Duell PB, Mehta V, Wong ND, Kalra D, Vijayaraghavan K, Puri R. Duell PB, et al. J Clin Lipidol. 2023 May-Jun;17(3):313-314. doi: 10.1016/j.jacl.2023.04.001. Epub 2023 Apr 17. J Clin Lipidol. 2023. PMID: 37117075 No abstract available.
Evidence regarding SGLT2 inhibitors for the management of diabetic dyslipidemia.
Seetharaman R, Joshi SS. Seetharaman R, et al. J Clin Lipidol. 2023 May-Jun;17(3):420-421. doi: 10.1016/j.jacl.2023.04.003. Epub 2023 Apr 26. J Clin Lipidol. 2023. PMID: 37137801 No abstract available.

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Management of diabetic dyslipidemia in Indians: Expert consensus statement from the Lipid Association of India

Affiliations

Management of diabetic dyslipidemia in Indians: Expert consensus statement from the Lipid Association of India

Authors

Affiliations

Abstract

Conflict of interest statement

Comment in

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