Goals Of Therapy And Management Considerations

Diabetic dyslipidemia plays an important role in the increased cardiovascular mortality and morbidity seen in patients with diabetes. There is robust evidence, coming from landmark secondary prevention trials described above as well as from recent meta-analyses (56), that LDL lowering is associated with significant reduction in cardiovascular risk in patients with diabetes. The optimal treatment strategy for such patients remains controversial. There are a number of guidelines on lipid lowering in diabetes, which are, for the most part, in agreement, but have some differences (Table 2). Both ADA (1) and ATP III (8) guidelines have identified LDL cholesterol as the first priority of lipid lowering, and the optimal level was set at <100 mg/dL (2.6 mmol/L). Furthermore, ATP III and the American Heart Association have designated most of the patients with diabetes at high-risk and recommended risk factor

TABLE 2 Guideline Target Levels for LDL Cholesterol, HDL Cholesterol, and Triglycerides for Patients with Diabetes
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