Management of dyslipidaemia in patients with comorbidities: facing the challenge: type 2 diabetes mellitus

Type 2 diabetes mellitus typically has the lipid features of elevated trigycerides, reduced HDL-cholesterol (both parts of the metabolic syndrome) and average or slightly elevated LDL-cholesterol. In consequence of hypertriglyceridemia, LDL particles are small and dense and therefore highly atherogenic. Outcome studies reveal that LDL-C lowering drugs have an above-average efficacy in type 2 diabetes as compared with non-diabetic patients. A minor increase of glycaemia in statin trials does not impair the beneficial cardiovascular results. Non-statin lipid lowering drugs do not impair glycaemia. Type 2 diabetes mellitus is now considered a major indication for lipid lowering drugs, thus there is a high value of and no major limitation for those compounds.