Lipid Management in Korean People With Type 2 Diabetes Mellitus: Korean Diabetes Association and Korean Society of Lipid and Atherosclerosis Consensus Statement

Abstract

Dyslipidemia in patients with diabetes is an important treatment target as a modifiable risk factor for cardiovascular disease (CVD). Although the primary treatment goal for dyslipidemia is to control low-density lipoprotein cholesterol (LDL-C), achieving this goal remains suboptimal according to recent studies. It is important to set the target goal for LDL-C control based on an accurate risk assessment for CVD. Here, we summarize the latest evidence on lipid management in patients with diabetes and present a consensus of the Korean Diabetes Association and Korean Society of Lipid and Atherosclerosis on the treatment goals of LDL-C according to the duration of diabetes, presence of CVD, target organ damage, or major cardiovascular risk factors. In patients with type 2 diabetes mellitus (T2DM) and CVD, an LDL-C goal of <55 mg/dL and a reduction in LDL-C level by 50% or more from the baseline is recommended. For the primary prevention of CVD in patients with T2DM with a duration of diabetes ≥10 years, major cardiovascular risk factors, or target organ damage, an LDL-C goal of <70 mg/dL is recommended. In patients with T2DM with a duration of diabetes <10 years and no major cardiovascular risk factors, an LDL-C goal of <100 mg/dL is recommended.

Combining Ezetimibe and Rosuvastatin: Impacts on Insulin Sensitivity and Vascular Inflammation in Patients with Type 2 Diabetes Mellitus

“…Notably, in the IMProved Reduction of Outcomes: Vytorin Efficacy International Trial (IMPROVE-IT), combining simvastatin (40 mg) with ezetimibe led to a further decrease in low-density lipoprotein cholesterol (LDL-C) level and better cardiovascular outcomes compared to simvastatin (40 mg) with placebo in adults age 50 years and older who had experienced acute coronary syndrome in the previous 10 days [ 4 ]. These results support the recommendations from current dyslipidemia management guidelines suggesting ezetimibe as an effective non-statin treatment option for high-risk patients with T2DM and established atherosclerotic cardiovascular disease [ 5 , 6 ].…”

Tailored Meal-Type Food Provision for Diabetes Patients Can Improve Routine Blood Glucose Management in Patients with Type 2 Diabetes: A Crossover Study

“…In contrast, the control group experienced significant deterioration in some aspects of its blood lipid status over time. In a randomized controlled trial investigating the effects of a Mediterranean diet on cardiovascular disease in patients with diabetes, the intervention group showed a 31% reduction in the risk of cardiovascular disease compared to the control group [ 24 ]. Guidelines for lipid management include reducing the intake of saturated fatty acids, cholesterol, and trans fats while increasing the intake of omega-3 fatty acids and dietary fiber [ 25 ].…”

Effect of Adding Apolipoprotein B Testing on the Prevalence of Dyslipidemia and Risk of Cardiovascular Disease in the Korean Adult Population

“…Meanwhile, in the present study, clinical information on subjects, including statin treatment, was limited, which might result in lipid profile results below the cutoff. Given that current clinical guidelines in Korea recommend the ApoB test for specific groups like patients with diabetes mellitus and familial hypercholesterolemia, the observed differences in dyslipidemia prevalence may be influenced by the characteristics of the population studied [ 19 , 29 , 30 ]. The public database in Korea, provided by the Health Insurance Review and Assessment Service (HIRA), offers information on the usage of reimbursed diagnostic tests through specialized electronic data interchange (EDI) code.…”

“…The lack of standardized analytical methods for ApoB tests has necessitated the assessment of different reference intervals across various analytical methods and populations [ 6 , 15 , 16 ]. Differences in cutoffs and reference intervals from various international guidelines for ApoB have been suggested, yet, there are no uniform cutoffs for ApoB in the Korean population [ 3 , 18 , 19 ]. Moreover, the impact of adding ApoB testing to the assessment of dyslipidemia prevalence and CVD risk in the Korean population has been less explored compared to Western populations [ 6 , 13 ].…”