Lipid Variability and Diabetes Mellitus

Abstract

Diabetic dyslipidemia is characterized by hypertriglyceridemia, low HDL (high-density lipoprotein)-cholesterol, elevated LDL (low-density lipoprotein)-cholesterol, and predominance of small dense LDL particles caused by insulin resistance in type 2 diabetes or insulin deficiency in type 1 diabetes. Dyslipidemia is a major risk factor for atherosclerotic cardiovascular disease in diabetes, and lowering lipid levels can reduce its morbidity and mortality. Current guidelines for dyslipidemia management recommend that the LDL-C goal be lower than 55~100 mg/dL depending on the underlying risk factors. However, higher visit-to-visit variability in cholesterol levels might be an independent predictor of major adverse cardiovascular events and poor renal outcomes in diabetes. In this review, we focused on clinical implications of lipid variability in diabetes.