A case report of dyslipidemia management in new-onset type 2 diabetic patient

Abstract

New-onset diabetes is a serious condition and is characterised by insulin resistance and dyslipidemia affecting adults and more lately children. Diabetic dyslipidemia is characterised by high plasma triglycerides and low-density lipoprotein cholesterol (LDL-C) particles, and low high-density lipoprotein cholesterol (HDL-C). Individuals with dyslipidemia have a high 10-year risk of atherosclerotic cardiovascular disease (ASCVD) and can be managed by adopting therapeutic lifestyle changes (TLC) and medication adherence. The new American College of Cardiology/American Heart Association (ACC/AHA) guideline emphasizes on matching the intensity of statin treatment to the level of ASCVD risk and replaces the old paradigm of LDL-C target based treatment, and the new guidelines of National Lipid Association (NLA) have recommended a multifaceted patient centered approach for the management of dyslipidemia. Both ACC/AHA and NLA have recommended statins as the main stay of drug therapy in patients with high cholesterol. Unlike ACC/AHA guidelines who do not recommend the use of nonstatin drugs except in the statin-intolerant patients, the NLA advocates nonstatins use in high-risk patients, and in patients with inherited cholesterol disorders, after statin therapy. Medication non adherence is a frequent problem in developing countries because of the low income and high cost of drugs which are sometimes required for a long duration of time. TLC has been reported to aid drug therapy to provide best medication benefit but lack of knowledge and illiteracy is another limitation to achieve maximum benefits from drug therapy in India.In conclusion, both TLC and medication adherence are important for dyslipidemia management with lipid lowering drugs in new-onset type 2 diabetic patient, and healthcare providers should provide knowledge on the benefits of TLC and medication adherence in countries with low income/socio-economic status.