Diagnostic and therapeutic procedures in lipid disorders in patients with diabetes – practical indications for physicians

Marcin Barylski; Paweł Bogdański; Agnieszka Mastalerz-Migas; Dorota Zozulińska-Ziółkiewicz

eISSN: 2450-4459
ISSN: 2450-3517

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6/2019
vol. 5

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abstract:

Guidelines/recommendations

Diagnostic and therapeutic procedures in lipid disorders in patients with diabetes – practical indications for physicians

Marcin Barylski

¹

,

Paweł Bogdański

²

,

Agnieszka Mastalerz-Migas

³

,

Dorota Zozulińska-Ziółkiewicz

⁴

Klinika Chorób Wewnętrznych i Rehabilitacji Kardiologicznej Uniwersytetu Medycznego w Łodzi, Uniwersytecki Szpital Kliniczny im. Wojskowej Akademii Medycznej – Centralny Szpital Weteranów, Łódź
Katedra i Klinika Chorób Wewnętrznych, Zaburzeń Metabolicznych i Nadciśnienia Tętniczego, Uniwersytet Medyczny w Poznaniu
Katedra i Zakład Medycyny Rodzinnej, Uniwersytet Medyczny we Wrocławiu
Katedra i Klinika Chorób Wewnętrznych i Diabetologii, Uniwersytet Medyczny w Poznaniu

Online publish date: 2020/03/11

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Lipid disorders affect more than 50% of patients diagnosed with type 1 and type 2 diabetes. They are often associated with atherogenic dyslipidaemia with characteristic coexistence of elevated triglycerides, the presence of small, dense, low-density lipoprotein (LDL) molecules, and low concentration of high-density (HDL) cholesterol in the serum. Cholesterol disorders are an important risk factor for cardiovascular events. Statin monotherapy is often insufficient to effectively correct the lipidogram. Even though the target LDL cholesterol level is reached, the residual cardiovascular risk remains significant. Therefore, current guidelines, as well as lowering LDL, also indicate the need to adjust the serum concentration of non-HDL cholesterol, which determines the total number of atherogenic molecules in plasma and better reflects cardiovascular risk. The optimal way to correct non-HDL cholesterol is by using combined treatment with statins and fenofibrate. The paper presents the latest 2019 European Society of Cardiology (ESC) and the European Atherosclerosis Society (EAS) guidelines regarding the treatment of lipid disorders, and the algorithm that facilitates the selection of diagnostic and therapeutic procedures.

keywords:

Diagnostic and therapeutic procedures in lipid disorders in patients with diabetes – practical indications for physicians

Marcin Barylski 1 , Paweł Bogdański 2 , Agnieszka Mastalerz-Migas 3 , Dorota Zozulińska-Ziółkiewicz 4

diabetes mellitus, atherogenic dyslipidaemia, cardiovascular risk, non-HDL cholesterol, combination therapy

Marcin Barylski

¹

,

Paweł Bogdański

²

,

Agnieszka Mastalerz-Migas

³

,

Dorota Zozulińska-Ziółkiewicz

⁴