Abstract
Dyslipidemia is one of the major cardiovascular risk factors especially for patients with type 2 diabetes mellitus. As a feature of the metabolic syndrome insulin resistance is also associated with an atherogenic lipoprotein phenotype. In type 1 diabetes inadequate glycemic control results in an increase of plasma triglyceride levels. The treatment of diabetic dyslipidemia is based on an improvement of glycemic control, in type 1 and type 2 diabetes, as well as in lifestyle recommendations, including dietary advice and physical exercise. The achievement of strict target levels, especially LDL-cholesterol values below 100 mg/dL, requires lipid lowering drug therapy. This LDL-cholesterol target level is based on the fact that diabetic patients reveal the same risk for myocardial infarction as non-diabetics after their first cardiovascular event. Thus the diagnosis of diabetes is regarded as an equivalent for manifest cardiovascular disease. The re-evaluation of large lipid intervention trials (4 S, CARE, LIPID, VA-HIT, Heart Protection Study) could clearly demonstrate also for the diabetic subpopulation that statin and fibrate therapy results in a significant reduction of the cardiovascular risk.
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