Management of Dyslipidemia in Patients with Diabetes

2011 ◽  
Vol 07 (01) ◽  
pp. 40
Author(s):  
Yu Kataoka ◽  
Kiyoko Uno ◽  
Stephen J Nicholls ◽  
◽  
◽  
...  
Keyword(s):  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Cardiovascular Prevention ◽  
Apparent Lack ◽  
Glucose Lowering ◽  
Major Morbidity ◽  
Ldl Particles ◽  
Patients With Diabetes ◽  
Cardiovascular Benefit

Cardiovascular disease is the leading cause of major morbidity and mortality in patients with type 2 diabetes. The recent focus on the apparent lack of cardiovascular benefit associated with glucose-lowering strategies has overshadowed the importance of targeting dyslipidemia for cardiovascular prevention in patients with diabetes. While lowering low-density lipoprotein (LDL) cholesterol is beneficial, diabetes is also characterized by hypertriglyceridemia, low levels of high-density lipoproteHDL-cholesterol and abundant levels of small, dense LDL particles. Accordingly, these factors represent additional targets for therapeutic modification in order to achieve more effective reductions in cardiovascular risk.

scholarly journals Statin prescription among patients with type 2 diabetes in Botswana: findings and implications

2019 ◽  
Author(s):  
Julius Chacha Mwita ◽  
Brian Godman ◽  
Tonya M Esterhuizen
Keyword(s):  
Type 2 Diabetes ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Secondary Data ◽  
Diabetes Clinic ◽  
Cholesterol Levels ◽  
Patients With Diabetes ◽  
Statin Prescription ◽  
Evidence Based Guideline

Abstract Background There is evidence of statin benefit among patients with diabetes regardless of their cholesterol levels or prior cardiovascular disease history. Despite the evidence, there is under-prescription of statins in clinical practice. This study aimed to assess statin prescriptions and associated factors among patients with type 2 diabetes in Botswana. Methods The study was a secondary data analysis of 374 randomly selected type 2 diabetes patients at a specialised diabetes clinic at Gaborone Botswana. We assessed the proportion of statin-eligible patients who are prescribed statins and evaluated the adjusted associations between various factors and statin prescription. Results Overall, 356 (95.2%) participants were eligible for a statin prescription. Clinicians prescribed statins in 162 (45.5%%; 95% confidence interval [CI]: 40.4% - 50.7%)) of eligible participants, and only one (5.5%) ineligible participant. The probability of statin prescription was high in participants with high baseline low-density lipoprotein cholesterol (risk ratio [RR]: 1.49; 95%CI: 1.17 - 1.89), increasing duration of diabetes (RR: 1.01; 95%CI 1.00 - 1.03) and the presence of chronic kidney disease (RR: 1.35; 95%CI: 1.06 - 1.74). Conclusion Most patients with type 2 diabetes are not receiving statins. Clinicians did not consider most guideline-recommended indications for statin prescription. The findings call for improvement in diabetes quality of care by implementing evidence-based guideline recommendations. Key words: statin, type 2 diabetes mellitus, prescription and Botswana

Pioglitazone reduces atherogenic dense low density lipoprotein (LDL) particles in patients with type 2 diabetes mellitus

2002 ◽  
Vol 2 (2) ◽  
pp. 143-148 ◽  
Author(s):  
Karl Winkler ◽  
Isolde Friedrich ◽  
Manfred W Baumstark ◽  
Heinrich Wieland ◽  
Winfried März
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Low Density ◽  
Ldl Particles

scholarly journals Statin prescription among patients with type 2 diabetes in Botswana: findings and implications

2019 ◽  
Author(s):  
Julius Chacha Mwita ◽  
Brian Godman ◽  
Tonya M Esterhuizen
Keyword(s):  
Type 2 Diabetes ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Secondary Data ◽  
Diabetes Clinic ◽  
Cholesterol Levels ◽  
Patients With Diabetes ◽  
Statin Prescription ◽  
Evidence Based Guideline

Abstract Background There is evidence of statin benefit among patients with diabetes regardless of their cholesterol levels or prior cardiovascular disease history. Despite the evidence, there is under-prescription of statins in clinical practice. This study aimed to assess statin prescriptions and associated factors among patients with type 2 diabetes in Botswana. Methods The study was a secondary data analysis of 500 randomly selected type 2 diabetes patients at a specialised diabetes clinic at Gaborone, Botswana. We assessed the proportion of statin-eligible patients who are prescribed statins and evaluated the adjusted associations between various factors and statin prescription. Results Overall, 477(95.4%) participants were eligible for statin prescription. Clinicians prescribed statins in 217 (45.5%%) of eligible participants, and only one(4.4%) ineligible participant. The probability of statin prescription was high in participants with high baseline low-density lipoprotein cholesterol (risk ratio [RR]: 1.49; 95%CI: 1.17-1.89), increasing duration of diabetes(RR: 1.01; 95%CI 1.00-1.03) and the presence of chronic kidney disease(RR: 1.35; 95%CI: 1.06-1.74). Conclusion Most patients with type 2 diabetes in Gaborone are not receiving statins. Clinicians did not consider most guideline-recommended indications for statin prescription. The findings call for improvement in diabetes quality of care by implementing evidence-based guideline recommendations.

scholarly journals Effects of Xuezhikang vs. Pravastatin on Triglyceride Level in Patients with Type 2 Diabetes Mellitus and Dyslipidemia: A Research Protocol for a Randomized Controlled Study

2021 ◽  
Author(s):  
Jin Xu ◽  
Xiao Du ◽  
Shilan Zhang ◽  
Qunyan Xiang ◽  
Liling Guo ◽  
...  
Keyword(s):  
Blood Lipids ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Primary Outcome Measure ◽  
Controlled Study ◽  
Open Label ◽  
Patients With Diabetes ◽  
Lipid Control ◽  
Postprandial Lipids

Abstract Background: Diabetes often accompanies with increase in triglyceride(TG) as well as small dense low density lipoprotein(sdLDL). Statins are difficult to completely correct this dyslipidemia. Xuezhikang, an extract of cholestin, is better than some statins in reducing TG. Under the condition of the similar decrease in LDL-cholesterol (LDL-C), it is not clear whether there is any difference in the effect of XZK and statins on TG reduction in patients with Type 2 DM(T2DM). Methods: An open-label multicenter study is planned to estimate the effects of Xuezhikang(1.2 g/d) and pravastatin(20 mg/d) on TG level and other blood lipids in T2DM patients with dyslipidemia and moderate to high risk of cardiovascular diseases. A total of 114 patients will be enrolled and randomly assigned (1:1 ratio) to accept Xuezhikang or pravastatin therapy for 6 weeks. The primary outcome measure is the change in fasting TG level after 6 weeks. The changes in other fasting lipids and postprandial lipids at 1, 2, 4 h after a nutritious breakfast will also be explored. The planned duration for enrollment is between November 2021 and December 2022. Conclusion: This study will evaluate the effect of 6-week treatment of Xuezhikang(1.2 g/d) and pravastatin(20 mg/d) on fasting TG level and other blood lipids in T2DM patients with dyslipidemia, which may provide a more optimized schedule for lipid control in patients with diabetes and dyslipidemia in primary prevention.

Subclinical Diastolic Dysfunction and Its Correlation with Laboratory Parameters in Type 2 Diabetes Mellitus in India: A Case Control Study

2018 ◽  
Vol 25 (2) ◽  
pp. 157-164
Author(s):  
◽  
Rajesh Kumar Meena ◽  
Sourabh Sharma ◽  
Soumya Sudharsan ◽  
Priyanka Kumari
Keyword(s):  
Diabetes Mellitus ◽  
Diastolic Dysfunction ◽  
Systolic Dysfunction ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Left Ventricular ◽  
Patients With Diabetes ◽  
Study Population ◽  
Diabetic Population

Abstract Background: This study was conducted to evaluate left ventricular dysfunction in diabetics and to find correlation with glycemic control and biochemical parameters compared to non-diabetic population. Methods: Thirty type 2 diabetics and thirty nondiabetic controls were recruited. Age, sex, body mass index of the controls were matched. Results: Mean duration of diabetes mellitus in study population was 10.97± 4.01years. Among study population both cases and controls had ejection fraction >55%( no systolic dysfunction). Among cases(n=16) 53.3% were having mean E/A ratio <1 and(n=14) 46.67% were had mean E/A ratio >1. In controls all of them had mean E/A ratio above 1. This difference of mean E/A ratio among cases and controls was statistically significant (p<0.001). Among patients with diabetes, 9.09% cases with a HbA1cbetween 6-7%, 33.33% between 7.1-8%, respectively 100% of cases with HbA1c>8.1% had diastolic dysfunction the differences between groups being statistically significant (p<0.001). Low density lipoprotein( LDL) was weakly and negative correlated with E/A ratio (r = - 0.38) while fasting blood sugar (r = -0.53) respectively Hemoglobin A1c (r = -0.66) were moderately and negatively correlated. All these correlations were statistically significant. Conclusion: Subclinical diastolic dysfunction is prevalent among diabetic population. Diastolic dysfunction in patients with diabetes was correlated with FBS, HbA1C and LDL.

Comparison of a direct enzymatic assay and polyacrylamide tube gel electrophoresis for measurement of small, dense low-density lipoprotein cholesterol

2015 ◽  
Vol 53 (1) ◽  
Author(s):  
Somlak Vanavanan ◽  
Pornpen Srisawasdi ◽  
Mana Rochanawutanon ◽  
Jirapa Kerdmongkol ◽  
Martin H. Kroll
Keyword(s):  
Gel Electrophoresis ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Cardiovascular Prevention ◽  
Lipoprotein Cholesterol ◽  
Low Density ◽  
Low Density Lipoprotein Cholesterol ◽  
Lipoprotein Particles ◽  
Ldl Particles

AbstractSmall, dense low-density lipoprotein cholesterol (sdLDL-C) has been linked to the progression of cardiovascular disease. We compared two methods for determination of sdLDL-C, a direct enzymatic (ENZ) method and a polyacrylamide tube gel electrophoresis (PGE) assay, and investigated the associations of both sdLDL-C measurements with metabolic syndrome.We analyzed 242 patient sera for sdLDL and atherosclerosis-related markers. The PGE method separates the intermediate-density lipoprotein particles into three midbands (MID-A to MID-C) and the LDL particles into seven subfractions (LDL1 to LDL7); the sdLDL-PGE result is calculated as the sum of cholesterol concentrations from LDL3 to LDL7.The regression equation for sdLDL-C was [ENZThe ENZ assay for sdLDL-C correlated well with the PGE method. The ENZ method measures a broader range of atherogenic lipoprotein particles than PGE and has the potential to identify subjects with vascular risk, thus contributing in directing specific interventions for cardiovascular prevention.

scholarly journals Statin prescription among patients with type 2 diabetes in Botswana: findings and implications

2020 ◽  
Author(s):  
Julius Chacha Mwita ◽  
Brian Godman ◽  
Tonya M Esterhuizen
Keyword(s):  
Type 2 Diabetes ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Secondary Data ◽  
Diabetes Clinic ◽  
Cholesterol Levels ◽  
Patients With Diabetes ◽  
Statin Prescription ◽  
Evidence Based Guideline

Abstract Background There is evidence of statin benefit among patients with diabetes regardless of cholesterol levels or prior cardiovascular disease history. Despite the evidence, there is under-prescription of statins in clinical practice. This study aimed to assess statin prescriptions and associated factors among patients with type 2 diabetes in Botswana. Methods The study was a secondary data analysis of 500 randomly selected type 2 diabetes patients at a specialised diabetes clinic at Gaborone, Botswana. We assessed the proportion of statin-eligible patients who are prescribed statins and evaluated the adjusted associations between various factors and statin prescriptions. Results Overall, 477 (95.4%) participants were eligible for a statin prescription. Clinicians prescribed statins in 217 (45.5%) of eligible participants, and only one (4.4%) ineligible participant. The probability of a statin prescription was higher in participants with high baseline low-density lipoprotein cholesterol (risk ratio [RR]: 1.49; 95%CI: 1.17-1.89), increasing duration of diabetes (RR: 1.01; 95%CI 1.00-1.03) and the presence of chronic kidney disease (RR: 1.35; 95%CI: 1.06-1.74). Conclusion A large proportion with type 2 diabetes in Gaborone is not receiving statins. Clinicians did not consider most guideline-recommended indications for statin prescriptions. The findings call for improvement in diabetes quality of care by implementing evidence-based guideline recommendations. Keywords: statin, type 2 diabetes mellitus, prescription and Botswana

scholarly journals Transvascular Low-Density Lipoprotein Transport in Patients With Diabetes Mellitus (Type 2)

2002 ◽  
Vol 22 (7) ◽  
pp. 1168-1174 ◽  
Author(s):  
Karen Kornerup ◽  
Børge Grønne Nordestgaard ◽  
Bo Feldt-Rasmussen ◽  
Knut Borch-Johnsen ◽  
Kurt Svarre Jensen ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Diabetes Mellitus Type 2 ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Diabetes Mellitus Type ◽  
Low Density ◽  
Patients With Diabetes

scholarly journals LRP1-Mediated AggLDL Endocytosis Promotes Cholesteryl Ester Accumulation and Impairs Insulin Response in HL-1 Cells

Cells ◽  
2020 ◽  
Vol 9 (1) ◽  
pp. 182
Author(s):  
Virginia Actis Dato ◽  
Aleyda Benitez-Amaro ◽  
David de Gonzalo-Calvo ◽  
Maximiliano Vazquez ◽  
Gustavo Bonacci ◽  
...  
Keyword(s):  
Cholesteryl Ester ◽  
Intracellular Signaling ◽  
Glucose Transporter ◽  
Low Density Lipoprotein ◽  
Insulin Response ◽  
Density Lipoprotein ◽  
Ldl Particles ◽  
Density Lipoprotein Receptor ◽  
Signaling Activation

The cardiovascular disease (CVD) frequently developed during metabolic syndrome and type-2 diabetes mellitus is associated with increased levels of aggregation-prone small LDL particles. Aggregated LDL (aggLDL) internalization is mediated by low-density lipoprotein receptor-related protein-1 (LRP1) promoting intracellular cholesteryl ester (CE) accumulation. Additionally, LRP1 plays a key function in the regulation of insulin receptor (IR) and glucose transporter type 4 (GLUT4) activities. Nevertheless, the link between LRP1, CE accumulation, and insulin response has not been previously studied in cardiomyocytes. We aimed to identify mechanisms through which aggLDL, by its interaction with LRP1, produce CE accumulation and affects the insulin-induced intracellular signaling and GLUT4 trafficking in HL-1 cells. We demonstrated that LRP1 mediates the endocytosis of aggLDL and promotes CE accumulation in these cells. Moreover, aggLDL reduced the molecular association between IR and LRP1 and impaired insulin-induced intracellular signaling activation. Finally, aggLDL affected GLUT4 translocation to the plasma membrane and the 2-NBDG uptake in insulin-stimulated cells. We conclude that LRP1 is a key regulator of the insulin response, which can be altered by CE accumulation through LRP1-mediated aggLDL endocytosis.

Sign in / Sign up

Export Citation Format

Share Document