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Clinical dilemmas in lipid management

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Dr Prakash Deedwania, USA    30 November 2017

Diabetes is a vascular disease and most patients with diabetes die from CV complications. Diabetes is associated with 2 4 fold increase in the risk of MI stroke CHD and heart failure. Most of the macrovascular MI stroke as well as microvascular retinopathy nephropathy neuropathy complications of diabetes can be prevented by comprehensive management of risk factors including lifestyle changes BP dyslipidemia and hyerglycemia. Of all the risk factors management of dyslipidemia especially with high intensity statins provides the maximum benefit in terms of reduction in risk of CV events. Although diabetic patients have multiple complex lipid abnormalities based on currently available evidence from large RCTs most national international guidelines recommend treatment with moderate to high intensity statins in all patients with diabetes regardless of the presence or absence of CV disorder. Additional therapy with fibrates might be needed in select individuals to control hypertriglyceridemia.

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