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Lipid-lowering in diabetes: An update.
- Source :
-
Atherosclerosis [Atherosclerosis] 2024 Jul; Vol. 394, pp. 117313. Date of Electronic Publication: 2023 Oct 06. - Publication Year :
- 2024
-
Abstract
- Atherosclerotic cardiovascular disease (ASCVD) is accelerated in people with diabetes. Dyslipidemia, hyperglycemia, oxidative stress, and inflammation play a role via a variety of mechanisms operative in the artery wall. In addition, some unique features predispose people with type 1 diabetes to accelerated atherosclerosis. Various organizations have created guidelines that provide advice regarding screening, risk assessment, and roadmaps for treatment to prevent ASCVD in diabetes. Management of dyslipidemia, especially with statins, has proven to be of immense benefit in the prevention of clinical CVD. However, since many patients fail to attain the low levels of low-density lipoproteins (LDL) recommended in these guidelines, supplemental therapy, such as the addition of ezetimibe, bempedoic acid or PCSK9 inhibitors, is often required to reach LDL goals. As a result, the upfront use of combination therapies, particularly a statin plus ezetimibe, is a rational initial approach. The addition to statins of drugs that specifically lower triglyceride levels has not proven beneficial, although the addition of icosapent-ethyl has been shown to be of value, likely by mechanisms independent of triglyceride lowering. Newer treatments in development, including apoC-III and ANGPTL3 inhibitors, seem promising in further reducing apoB-containing lipoproteins.<br />Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.<br /> (Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.)
- Subjects :
- Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors therapeutic use
Hypolipidemic Agents therapeutic use
Drug Therapy, Combination
Atherosclerosis drug therapy
Atherosclerosis blood
Atherosclerosis prevention & control
Biomarkers blood
Treatment Outcome
Ezetimibe therapeutic use
Diabetes Mellitus, Type 1 drug therapy
Diabetes Mellitus, Type 1 diagnosis
Diabetes Mellitus, Type 1 blood
Diabetes Mellitus, Type 1 complications
Anticholesteremic Agents therapeutic use
Dyslipidemias drug therapy
Dyslipidemias blood
Dyslipidemias diagnosis
Subjects
Details
- Language :
- English
- ISSN :
- 1879-1484
- Volume :
- 394
- Database :
- MEDLINE
- Journal :
- Atherosclerosis
- Publication Type :
- Academic Journal
- Accession number :
- 37945448
- Full Text :
- https://doi.org/10.1016/j.atherosclerosis.2023.117313