Future perspectives of the pharmacological management of diabetic dyslipidemia.

Authors:
Angelo Maria Patti
Angelo Maria Patti
University of Palermo
Italy
Rosaria Vincenza Giglio
Rosaria Vincenza Giglio
University of Palermo
Italy
Nikolaos Papanas
Nikolaos Papanas
Democritus University of Thrace
Greece
Manfredi Rizzo
Manfredi Rizzo
University of Palermo
Italy
Ali A Rizvi
Ali A Rizvi
University of South Carolina School of Medicine
United States

Expert Rev Clin Pharmacol 2019 Feb 22;12(2):129-143. Epub 2019 Jan 22.

c Division of Endocrinology , Diabetes and Metabolism University of South Carolina School of Medicine Columbia , South Carolina , SC , USA.

Introduction: Diabetic dyslipidemia is frequent among patients with type 2 diabetes mellitus (T2DM) and is characterized by an increase in triglycerides (TGs), low-density lipoprotein cholesterol (LDL-C), and small-dense (atherogenic) particles, and by a decrease in low high-density lipoprotein cholesterol (HDL-C) and apolipoprotein (Apo) A1 that are strongly related to insulin resistance. The increased flux of free fatty acids from adipose tissue to the liver aggravates hepatic insulin resistance and promotes all of aspects of the dyslipidemic state. Areas covered: Statins are the first-line agents for treatment while other lipid-lowering drugs (ezetimibe, fibrate and proprotein convertase subtilisin/kexin type 9) or novel anti-diabetic agents (dipeptidyl peptidase-4 inhibitors (DPP-4is), glucagon like peptide-1 receptor agonist (GLP-1RA), sodium/glucose cotransporter 2 inhibitors (SGLT2is)) or nutraceuticals (berberine, omega 3 fatty acid, red yeast rice) can be used alone or in combination. Expert commentary: In patients with T2DM, lipid abnormalities should be identified and treated as part of the overall diabetic treatment, in order to prevent cardiovascular disease. The choice of drugs to be used is mainly based on the lipid profile and on the characteristic lipoprotein abnormalities; the use of new drugs for the treatment of hyperglycemia and lipids alteration in these patients can improve diabetic dyslipidemia.

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https://www.tandfonline.com/doi/full/10.1080/17512433.2019.1
Publisher Site
http://dx.doi.org/10.1080/17512433.2019.1567328DOI Listing

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February 2019
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