Management of diabetic dyslipidemia: An update

Jialal, Ishwarlal; Singh, Gurdeep

doi:10.4239/wjd.v10.i5.280

Cited by 79 publications

(63 citation statements)

References 65 publications

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“…There are many factors that contribute to the development of atherosclerotic cardiovascular disease, the main mortality cause in T2DM patients. These include dyslipidemia, increased oxidative stress, enhanced protein glycation or chronic inflammatory state all of them worsen in T2DM [ 32 ]. Statins are the gold standard treatment for the prevention and management of cardiovascular disease and their use in T2DM patients is recommended by The American Diabetes Association 2019 guidelines [ 33 ].…”

Section: Beneficial Effects Of Statins On Diabetic Complication Anmentioning

confidence: 99%

Statin Treatment-Induced Development of Type 2 Diabetes: From Clinical Evidence to Mechanistic Insights

Galicia-García

Jebari

Larrea-Sebal

et al. 2020

IJMS

101

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Statins are the gold-standard treatment for the prevention of primary and secondary cardiovascular disease, which is the leading cause of mortality worldwide. Despite the safety and relative tolerability of statins, observational studies, clinical trials and meta-analyses indicate an increased risk of developing new-onset type 2 diabetes mellitus (T2DM) after long-term statin treatment. It has been shown that statins can impair insulin sensitivity and secretion by pancreatic β-cells and increase insulin resistance in peripheral tissues. The mechanisms involved in these processes include, among others, impaired Ca2+ signaling in pancreatic β-cells, down-regulation of GLUT-4 in adipocytes and compromised insulin signaling. In addition, it has also been described that statins’ impact on epigenetics may also contribute to statin-induced T2DM via differential expression of microRNAs. This review focuses on the evidence and mechanisms by which statin therapy is associated with the development of T2DM. This review describes the multifactorial combination of effects that most likely contributes to the diabetogenic effects of statins. Clinically, these findings should encourage clinicians to consider diabetes monitoring in patients receiving statin therapy in order to ensure early diagnosis and appropriate management.

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Section: Beneficial Effects Of Statins On Diabetic Complication Anmentioning

confidence: 99%

Statin Treatment-Induced Development of Type 2 Diabetes: From Clinical Evidence to Mechanistic Insights

Galicia-García

Jebari

Larrea-Sebal

et al. 2020

IJMS

101

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“…Irrespective of the currently available armamentarium in the management of T2DM and related conditions, lifestyle adjustments and the primary prevention of T2DM, CHD or dyslipidemia remain of uttermost importance [26]. Lifestyle interventions remain, however, difficult to implement, even in subjects who are aware of the risks of an unhealthy diet and of sedentarism, such as medical students and physicians [27][28][29].…”

Section: Discussionmentioning

confidence: 99%

Dyslipidemia: A Trigger for Coronary Heart Disease in Romanian Patients with Diabetes

et al. 2020

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Previous studies have reported age and gender disparities in the occurrence and therapeutic approach of dyslipidemia and (or) coronary heart disease (CHD) in patients with type 2 diabetes mellitus (T2DM). We aimed to investigate these differences in Romanian patients with T2DM. A cross-sectional, observational, retrospective study was conducted using the medical records of T2DM patients who attended the outpatient facility of the Internal Medicine Clinic of the Clinical Emergency Hospital of Bucharest, Romania for routine check-ups in a six-month period. We analyzed the records of 217 diabetic patients (mean age 69 ± 11 years; 51.15% women). We found no significant gender differences in the occurrence of dyslipidemia, CHD or CHD + dyslipidemia or in terms of statin prescription. However; patients aged 65 years or older were significantly more affected by dyslipidemia, CHD or CHD + dyslipidemia, versus subjects aged <65 years. Further, they were more likely to be prescribed statin therapy (p < 0.0001 for all). Statins were prescribed to 67.24% of the patients with dyslipidemia; 61.01% of the subjects with CHD; and to 91.48% of the patients who had both conditions. e recorded no gender differences in the occurrence of CHD and (or) dyslipidemia in Romanian T2DM patients. Patients aged 65 years or older had a higher prevalence of CHD and/or dyslipidemia, and were more likely to be prescribed statins, versus younger counterparts. However, many T2DM patients with CHD and (or) dyslipidemia were undertreated: Nearly 33% of the subjects with dyslipidemia, and nearly 40% of the ones with CHD were not prescribed statins.

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“…Other cardiometabolic risk conditions, not directly linked to LDL‐C levels, are known to contribute to the pathophysiology and the clinical manifestations of ASCVD. Whether these conditions, such as the insulin resistance state, characteristic of the metabolic syndrome, and the so‐called 'diabetic dyslipidemia’ 88 may also contribute to the effects of PCSK9 inhibitors on ASCVD outcomes is to be established.…”

Section: Pcsk9 and Pharmacological Approachesmentioning

confidence: 99%

PCSK9 and atherosclerosis: Looking beyond LDL regulation

Ragusa

Basta

Neglia

et al. 2020

Eur J Clin Investigation

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Proprotein Convertase Subtilisin/Kexin type 9 (PCSK9) is involved in cholesterol homeostasis. After binding to the complex low‐density lipoprotein (LDL)‐receptor, PCSK9 induces its intracellular degradation, thus reducing serum LDL clearance. In addition to the well‐known activity on the hepatic LDL receptor‐mediated pathway, PCSK9 has been, however, associated with vascular inflammation in atherogenesis. Indeed, PCSK9 is expressed by various cell types that are involved in atherosclerosis (e.g. endothelial cells, smooth muscle cells and macrophages) and is detected inside human atherosclerotic plaques. We here analyse the biology of PCSK9 and its possible involvement in molecular processes involved in atherosclerosis, beyond the regulation of circulating LDL cholesterol levels.

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Management of diabetic dyslipidemia: An update

Cited by 79 publications

References 65 publications

Statin Treatment-Induced Development of Type 2 Diabetes: From Clinical Evidence to Mechanistic Insights

Statin Treatment-Induced Development of Type 2 Diabetes: From Clinical Evidence to Mechanistic Insights

Dyslipidemia: A Trigger for Coronary Heart Disease in Romanian Patients with Diabetes

PCSK9 and atherosclerosis: Looking beyond LDL regulation

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