Management Of Diabetic Dyslipidemia Research Articles

Classical and Novel Lipid-Lowering Therapies for Diabetic Patients with Established Coronary Artery Disease or High Risk of Coronary Artery Disease-A Narrative Clinical Review.

Diabetic atherosclerosis is a complex process that is characterized by diffuse and unstable lesions increasing 2-4-fold the risk of adverse cardiovascular (CV) events. Diabetic dyslipidemia has a predominant role in coronary artery disease (CAD) and has been the target of classical and emerging pharmaceutical agents with established or promising CV benefits. The aim of the present narrative review was to summarize the effects of classical and novel lipid-lowering pharmaceutical agents on lipid profile and CV outcomes in diabetic patients with established CAD or high risk of CAD. Statins remain the first-line treatment for all diabetic patients since they considerably ameliorate lipid parameters and non-lipid CV risk factors, leading to reduced CV morbidity and mortality. Complementary to statins, ezetimibe exerts lipid-lowering properties with modest but significant reductions in major adverse cardiovascular events (MACEs) and CV mortality. PCSK9 inhibitors considerably reduce LDL-C levels and lower MACEs in diabetic patients. On the other hand, fibrates may confer a very modest decline in MACE incidence, while the CV impact of omega-3 fatty acids is promising but remains questionable. Bempedoic acid and inclisiran have a potential therapeutic role in the management of diabetic dyslipidemia, but this is still not adequately documented. Given the heightened CV risk among individuals with diabetes, more decisive results would be of great importance in the utility of all these drugs.

DIABETIC CARDIAC AUTONOMIC NEUROPATHY: SIMVASTATIN, INSULIN RESISTANCE AND LIPIDS

Treatment of diabetic cardiac autonomic neuropathy (CAN) is a complex process, that includes: lifestyle modification; reducing of insulin resistance (IR); optimal glycemic control; management of diabetic dyslipidemia; antioxidants; vitamins; treatment of myocardial metabolic abnormalities; thrombosis and others. The aim of study was to investigate the effects of simvastatin on insulin resistance and blood lipid profile parameters in patients with type 2 diabetes mellitus (T2DM) and the definite stage of cardiac autonomic neuropathy. The study involved 107 patients with T2DM among them 16 patients without CAN, 19 with subclinical stage of CAN and 72 with definite CAN. Median age of patients was 53.6 ± 0.41 yrs, disease duration - 4.12 ± 0.24 yrs and median glycated hemoglobin (HbA1c) - 7.01% ± 0.09%. The control group included 14 almost healthy people without DM. Patients with definite CAN were allocated into two treatment groups: 1st group - 22 patients received standard hypoglycemic therapy and simvastatin 20 mg/day; 2nd group - control (n = 15). The duration of the study was 3 mos. The concentrations of glucose, HbA1c, immunoreactive insulin (IRI) in the blood were determined. Lipid metabolism was assessed by the concentration of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG) measurements. The IR index (HOMA-IR), atherogenic coefficient (AC), TG/HDL-C parameters, and TG-glucose (TyG) index were calculated. It was established that in patients with T2DM with subclinical stage of CAN there was statistically significant increase in the parameters of HbA1c, IRI, TC, TG and HOMA-IR, AC, TyG indices and decrease of TG/HDL-C and HDL-C compared to control; increase of IRI, TG, TG/HDL-C and TyG indices compared to patients with T2DM without CAN. The definite stage of CAN is characterized by an increase of HbA1c, IRI, TC, LDL-C levels and HOMA-IR, AC indices and a significant decrease in the concentration of HDL-C (compared to patients with subclinical CAN). As a result of our study, we found out that prescription of simvastatin to patients with definite stage of CAN was accompanied by a statistically significant decrease in the concentration of TC, LDL-C, TG and an increase in the content of HDL-C (compared to 2nd, control group). Obtained results justify the appropriateness of statins prescription to patients with T2DM and the definite stage of CAN.

The Hypocholesterolemic and Glucose Modulatory Effect of Fibre Enriched Snack in Hyperlipidemic/Hyperglycemic Rat Model Induced by High Cholesterol and High Fructose Diet

Dietary interventions have been used in the management of hyperlipidemia. Incorporation of dietary fibre into food products enhances their nutritional value. This study was done to investigate the effect of a fibre enriched snack on the blood glucose level and lipid profile in hyperlipidemia-hyperglycemia - induced wistar albino rats. The rats (n=25) were divided into 5 groups, 1 - fed standard laboratory diet (Control), 2 - fed hyperlipidemic diet and 10% fructose solution, 3 - fed hyperlipidemic diet, 10% fructose solution alongside fibre enriched snack, 4- fed hyperlipidemic diet which was withdrawn before feeding fibre enriched snack, 5 - fed standard laboratory diet and fibre enriched snack, 6 - fed hyperlipidemic diet, 10% fructose solution and a conventional antilipemic drug (CAD). The duration of the experiment was for 6 weeks. Statistical analysis was done using graph pad prism 6.01 version. At the end of the experiment, it was found that the fibre enriched snack stabilized blood glucose levels, reduced serum total cholesterol (TC) (p<0.01) and low density lipoproteins (LDL) (p< 0.01) in the hyperlipidemic diet fed group. There was, however, no significant change in the triglycerides (TG) as well as the high-density lipoproteins (HDL) in the hyperlipidemic group fed with the fibre enriched snacks. The results indicate that the fibre enriched snack has hypoglycemic and hypolipidemic potential and could, therefore, serve as an effective dietary intervention in the management of diabetic dyslipidemia

Diabetic Cardiovascular Autonomic Neuropathy: Insulin Resistance, Lipids and Simvastatin

Background: Treatment of diabetic cardiac autonomic neuropathy (CAN) is a complex process, that includes: lifestyle modification; reducing of insulin resistance (IR); optimal glycemic control; management of diabetic dyslipidemia; antioxidants; vitamins; treatment of myocardial metabolic abnormalities; thrombosis and others. The aim of study was to investigate the effects of simvastatin on insulin resistance and blood lipid profile parameters in patients with type 2 diabetes mellitus (DM) and the definite stage of cardiac autonomic neuropathy. Methods: The study involved 107 patients with type 2 DM among them 16 patients without CAN, 19 with subclinical stage of CAN and 72 with definite CAN. Median age of patients was 53.6±0.41 years, disease duration - 4.12±0.24 years and median glycated hemoglobin (HbA1c) - 7.01%±0.09%. The control group included 14 almost healthy people without DM. Patients with definite CAN were allocated into two treatment groups: 1st group - 22 patients received standard hypoglycemic therapy and simvastatin 20 mg/day; 2nd group - control (n = 15). The duration of the study was 3 mos. The concentrations of glucose, HbA1c, immunoreactive insulin (IRI) in the blood were determined. Lipid metabolism was assessed by the concentration of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG) measurements. The IR index (HOMA-IR), atherogenic coefficient (AC), TG/HDL-C parameters, and TG-glucose (TyG) index were calculated. Result: It was established that in patients with type 2 DM with subclinical stage of CAN there was statistically significant increase in the parameters of HbA1c, IRI, TC, TG and HOMA-IR, AC, TyG indices and decrease of TG/HDL-C and HDL-C compared to control; increase of IRI, TG, TG/HDL-C and TyG indices compared to patients with type 2 DM without CAN. The definite stage of CAN is characterized by an increase of HbA1c, IRI, TC, LDL-C levels and HOMA-IR, AC indices and a significant decrease in the concentration of HDL-C (compared to patients with subclinical CAN). As a result of our study, we found out that prescription of simvastatin to patients with definite stage of CAN was accompanied by a statistically significant decrease in the concentration of TC, LDL-C, TG and an increase in the content of HDL-C (compared to 2nd, control group). Conclusion: Obtained results justify the appropriateness of statins prescription to patients with type 2 DM and the definite stage of CAN.

PCSK9 Inhibitors for the Management of Dyslipidemia in People with Type 2 Diabetes: How Low is Too Low?

Diabetic patients are considered to be at high risk for the development of atherosclerotic disease. Management of hypercholesterolemia is of paramount importance to optimize cardiovascular outcomes in this subset of patients and statins are regarded as the mainstay of treatment. However, the recent advent of PCSK-9 inhibitors has provided a useful alternative in the management of dyslipidemia, especially when statins cannot be tolerated or when hypolipidemic targets cannot be achieved. In this review, we discuss current trends in their use, and we focus on their role in the management of diabetic dyslipidemia.

2249-PUB: Current Practices and Gaps in Management of Dyslipidemia in Indian Participants with Type 2 Diabetes Mellitus (T2DM) in Alignment with American Association of Clinical Endocrinologists (AACE) Guidelines in LEADD (Learning with Experts to Advance Diabetes

Background: Dyslipidemia is a common co-morbid condition in participants with T2DM. AACE guidelines advocate moderate to high intensity statins in T2DM unless contraindicated. Objective: Assess evaluation practices and treatment patterns for dyslipidemia with statin intensity usage in the T2DM population as per AACE guidelines. Methods: Sub-analysis of prospective, cross sectional, observational LEADD study in T2DM participants, conducted at 226 sites Participants stratified basis risk status and mean LDL was compared to recommended LDL levels as per AACE guidelines. “n”=number of participants analyzed for each parameter. Results: Total of 4002 participants were evaluated and had mean (±SD) LDL - C levels of 117.7 ± 37.66 mg/dl. AACE Risk stratification with available data (n = 3538/4002) of participants was conducted on stratification 0.3% (n = 11/3538) participants were in high risk, 87.0% (n = 3077/3538) in very high risk and 12.7% (450/3538) in extreme risk category. Mean(±SD) LDL - C was 116.8 (± 36.41), 118.1 (±38.04) and 118.4 (± 41.39) mg/dl as against goal of <100, <70 and <55mg/dl for high risk, very high risk and extreme risk groups. 77.5% (n = 1523/1964) participants evaluated for dyslipidemia received Rosuvastatin. Percentage participants not on LDL- C goal were 54.54%, 89.88% and 94.77% in high risk, very high risk and extreme risk. 87.44% (n = 1962/2244), and 77.69% (n = 282/363 in very high risk and extreme risk group did not receive moderate to high intensity statin as recommended by AACE. Conclusion: AACE guidelines adherence for evaluation and management of diabetic dyslipidemia is sub-optimal in study population. Although population falling in very high to extreme risk, they were not treated with moderate to high intensity statins. Reasons for these findings require further research. Disclosure A. Unnikrishnan: Other Relationship; Self; Abbott, AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Dr. Reddys Laboratories, Eli Lilly and Company, Eris Pharmaceuticals, Ipca Laboratories Ltd., MSD, Novartis Pharmaceuticals Corporation, Novo Nordisk A/S, Sanofi. A.K. Das: None. B.D. Saboo: None. S. Kalra: None. V. Ayyar: None. M.H. Tiwaskar: None. Funding Diabetes Care India; Dr. Reddy's Laboratories

Update on the Management of Diabetic Dyslipidaemia

Diabetic dyslipidaemia (DD) comprises a complex group of potentially atherogenic lipid and lipoprotein abnormalities, including both quantitative and qualitative changes. It is characterised by low high-density lipoprotein cholesterol, elevated low-density lipoprotein cholesterol (LDL-C), and a higher prevalence of small, dense LDL particles, as well as elevated fasting and postprandial triglycerides. Patients with Type 2 diabetes mellitus have an increased prevalence of lipid abnormalities and controlling dyslipidaemia in these patients has a big impact on morbidity and mortality. Lifestyle changes are still the pillar of treatment for DD and statins are the drugs of choice that decrease LDL-C and reduce cardiovascular events and cardiovascular death, either in primary or secondary prevention, in diabetic patients. Pitavastatin has a number of pleiotropic effects that reduce the metabolic changes associated with adiposity and improve glucose metabolism, which distinguishes it from other statins. New treatments, such as PCSK9 inhibitors, have proven to be powerful LDL-C-lowering agents; however, the need for long-term safety studies and the high associated costs are the main challenges. Future treatments, such as an intracellular PCSK9 inhibitor, a dual proliferator-activated receptor-alpha/gamma agonist, and bempedoic acid, are in development. The aim of this article is to review the pathophysiology of DD and discuss its role in cardiovascular event risk and treatment, as well as to study the effects of lipid-lowering therapy on glucose metabolism and the outcomes of antidiabetic treatment on dyslipidaemia.

PPAR α/γ Agonist in Management of Diabetic Dyslipidemia: A Review

PPAR α/γ Agonist in Management of Diabetic Dyslipidemia: A Review

Saroglitazar for the treatment of hypertrig-lyceridemia in patients with type 2 diabetes: current evidence.

Diabetes mellitus (DM) is one of the most dreaded metabolic disorders in the world today. It is the leading cause of morbidity and mortality, and plays a cardinal role in quality of life and health economics. DM is associated with a high prevalence of microvascular and macrovascular complications. DM is a very important cardiovascular (CV) risk factor. Cardiovascular disease (CVD) has been implicated as the prime cause of mortality and morbidity in patients with DM. Hence, treatment of DM goes beyond glycemic control, and demands a multidisciplinary approach that comprehensively targets risk factors inherent in CV events. Lipid abnormalities are undoubtedly common in patients with DM, and they contribute to an increased risk of CVD. A high-risk lipid profile, termed atherogenic dyslipidemia of diabetes (ADD), is known to occur in patients with DM. The use of lipid-lowering agents, a quintessential part of the multifactorial risk factor approach, is a crucial intervention to minimize diabetes-related complications. In this article, we discuss the role of peroxisome proliferator activator receptor (PPAR) alpha/gamma (α/γ) agonist, saroglitazar, in the management of ADD. While statins are irrefutably the first line of drugs for dyslipidemia management in patients with residual CV risk while on a statin, PPAR α/γ agonists have been found to be of substantial benefit. Data from the PRESS I–VI clinical trials testify to the fact that saroglitazar and fibrates have similar efficacy in reducing triglycerides and improving high-density lipoprotein. The ancillary benefit of improved glycemic control, without the weight gain of PPAR γ agonists, is an added advantage. Reduction in ADD, improved glycemic control, efficacy at par with fibrates, and an acceptable safety profile form the grounds on which this group of PPAR α/γ agonists, with their novel mechanism, holds a promising future in the management of diabetic dyslipidemia.

Glucagon-like peptide-1 as a key regulator of lipid and lipoprotein metabolism in fasting and postprandial states.

Insulin resistance and the metabolic syndrome are associated with fasting and postprandial dyslipidemia. This involves the hepatic and intestinal overproduction of very low density lipoproteins (VLDL) and chylomicron particles, respectively, which give rise to atherogenic remnants upon lipolysis in the circulation. Recently, the insulin secretagogue glucagon-like peptide-1 (GLP-1) has received attention not only as an anti-diabetic therapy for regulating glycaemia, but also as a regulator of lipid and lipoprotein metabolism. In fact, agents that raise endogenous bioactive levels of GLP-1 (dipeptidyl peptidase 4 inhibitors) and agents that directly stimulate GLP-1 receptors (GLP-1 receptor agonists) have been assessed in both preclinical and clinical trials for their ability to modulate plasma lipid parameters. Here we describe current evidence supporting a role for GLP-1 in preventing elevated intestinal chylomicron output and postprandial hypertriglyceridemia--an independent predictor of cardiovascular risk. Furthermore, we examine a role for GLP-1 in regulating fasting hepatic VLDL production and hindering the development of a potentially devastating comorbidity, hepatic steatosis. Possible mechanisms of action of GLP-1 are discussed including a reduction in intestinal absorption of dietary lipid and enhanced hepatic fatty acid oxidation or autophagy. Finally, we discuss the current controversy over whether these effects could occur via direct receptor stimulation or alternative, indirect pathways. We conclude that GLP- 1-based therapies appear promising in the management of diabetic dyslipidemia, and further studies are warranted to elucidate their mechanisms of action in both the intestine and liver.

Lipid Levels and Associated Cardiovascular Risk Factors in Moroccan Type 2 Diabetes: A Case Control Study (EPIDIAM Study)

Background: The management of diabetic dyslipidaemia, a well-recognized and modifiable risk factor, is a key element in the multifactorial approach to prevent cardiovascular diseases (CVD) in individuals with type 2 diabetes (T2DM). Objective: The aim of this study is to describe lipids profile and to compare CVD risk factors in Moroccan individuals with and without T2DM. Subjects and Methods: The study population consisted of 1307 unrelated T2D and 984 non-diabetics subjects. This was a case control study carried out in urban and rural primary health care centers. The survey was conducted from January 2006 to July 2008. Results: This case control study performed in a group of type 2 diabetic patients (1307) and non-diabetic (984) adults’ shows that T2D is strongly and independently associated with CVD risk factors, which are, hypertension (OR 4.06, 95% CI: 3.35-4.93, p <0.001), elevated TGs (OR 1.77, CI: 1.45-2.18, p <0.001), central obesity (OR 1.67, CI: 1.30-2.16, p <0.001), been female (OR 0.79, CI: 0.64-0.97, p =0.022), and been older-age (p =0.001). Strong prevalence of CVD risk factors has also shown among non-diabetics. Conclusion: The present study has found a high prevalence of CVD risk factors among T2D patients and controls despite the significant difference between them. Keywords: Type 2 Diabetes Mellitus, Dyslipidaemia, Cardiovascular disease, Risk factors, Morocco. Read more →

Update on the research of diabetic dyslipidemia

Dyslipidemia is one of the major risk factors for cardiovascular disease in diabetes mellitus,but clinical practices in the management of diabetic dyslipidemia are still not satisfactory in China.The cornerstone of treatment for diabetic dyslipidemia consists of therapeutic lifestyle change and statins.Recent guidelines emphasize aggressive low density lipoprotein-cholesterol control with statins.However,intensive statin therapy may increase the risk of myopathy and diabetes.Therefore,it is important to consider its risk benefit ratio in individual patients.The additional benefit of statins in combination with other hypolipidemic drugs on cardiovascular risk needs verifying by further investigation. Key words: Diabetes mellitus; Cardiovascular disease; Dyslipidemia

A potential role of Lavandula angustifolia in the management of diabetic dyslipidemia

Diabetic dyslipidemia is a key contributor to insulin resistance and a risk factor for cardiovascular complications in patients with DM type 2. Lavandula angustifolia (lavender) is native of the northern region of Jordan and has been long used in Jordanian folkloric medicine in the management of diabetes. To our knowledge, this is the first manuscript to study the potential role of the methanolic extract of the plant in the management of diabetic dyslipidemia. Our results demonstrated in vitro inhibitory effects of L. angustifolia on both hormone sensitive lipase (HSL) and pancreatic lipase (PL) activities. The results indicated that lavender extract inhibited HSL activity in a dose dependent manner with an IC50 of 175.5 µg/ml. Likewise, it inhibited the PL activity in a dose dependent manner with an IC50 of 56.5 µg/ml. Such inhibitory activities could be attributed, but is not exclusive, to the presence of rosmarinic acid (IC50 of 125.2 and 51.5 µg/ml for PL and HSL, respectively) and gallic acid (IC50 of 10.1 and 14.5 µg/ml for PL and HSL, respectively) in the extract. Interestingly, the inhibitory pattern of the lavender on the enzymatic activities of HSL and PL matched the inhibitory pattern of orlistat. Key words: Lavender, hormone sensitive lipase, pancreatic lipase, obesity, diabetes mellitus, medicinal plants.

Fibrate Therapy in the Management of Diabetic Dyslipidemia: There is No ACCORD to be Found

Mixed dyslipidemia is a complex clinical entity that contributes significantly to the increased risk for cardiovascular morbidity and mortality that is observed in patients with type 2 diabetes mellitus. Insulin resistance is associated with reduced serum lipoprotein lipase activity, increased serum levels of very low-density lipoproteins and triglyceride, low serum high-density lipoproteins, and increased concentrations of small, dense low-density lipoproteins. Combinations of medications are frequently required in order to achieve guideline-specified goals for the various lipid fractions of diabetic patients. The fibric acid derivatives (fibrates) are effective agents for raising serum levels of high-density lipoproteins and decreasing levels of triglycerides. A number of trials have demonstrated that among patients with high triglycerides and low HDL, fibrates do beneficially impact cardiovascular morbidity in diabetic and nondiabetic individuals. The Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial suggests that the addition of fenofibrate to ongoing statin therapy in patients with type 2 diabetes mellitus offers limited benefit.

Management of diabetic dyslipidemia with subatmospheric dehydrated barley grass powder

Management of diabetic dyslipidemia with subatmospheric dehydrated barley grass powder

Management of diabetic dyslipidemia with subatmospheric dehydrated barley grass powder

Diabetes is a chronic, potentially debilitating and often fatal disease. The prevalence of type 2 diabetes is increasing in all populations worldwide. The investigation was carried out to study the impact of barley grass powder (BGP) supplementation on the carbohydrate and lipid metabolism of stable type 2 diabetes mellitus (T2DM) subjects. A total of 59 stable type 2 diabetic subjects were enrolled in the study from pathology laboratories and divided into experimental (n=36) and control groups (n=23). BGP (1.2 g/day) in the form of capsules (n=4) was given to the experimental group subjects for a period of 60 days. Fasting blood sugar (FBS), glycated haemoglobin (HbA1c) and lipid profile levels were monitored at baseline and at 60 days. Paired t test was applied using Microsoft® Office Excel 2003. Supplementation with BGP resulted in a significant decrease in FBS, HbA1c, total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) and non–high-density lipoprotein cholesterol (Non–HDL-C) and a significant increase in highdensity lipoprotein cholesterol (HDL-C) levels. In conclusion, the results obtained suggest that BGP holds promise to be used as a functional food to optimise the health of diabetic subjects. Key words: Barley grass powder, diabetes, fasting blood sugar, lipid levels

Therapy and clinical trials: management of diabetic dyslipidemia

Therapy and clinical trials: management of diabetic dyslipidemia

Diabetic Dyslipidemia and Atherosclerosis

Atherosclerosis is the primary cause of death in patients with type 2 diabetes mellitus (DM) and it seems to be closely related to a specific cluster of lipid abnormalities, including low levels of high-density lipoprotein cholesterol, increased numbers of small dense low-density lipoprotein particles, and elevated triglyceride levels. Each of these abnormalities is associated with an increased risk for cardiovascular morbidity and mortality. This review describes the atherogenic dyslipidemia that characterizes type 2 DM, the causes of this so-called diabetic dyslipidemia, and pharmacologic approaches to normalizing the lipid profile in these patients. The management of patients with type 2 DM usually centers on glycemic and blood pressure control. Most of the commonly used antidiabetic agents have neutral or only mildly beneficial effects on diabetic dyslipidemia; thus, achieving better glycemic control may only slightly improve the lipid profile. Treatment of dyslipidemia usually requires pharmacotherapy to achieve major improvements in lipid profiles, yet current management of diabetic dyslipidemia generally is not optimal. Even when treated with statins, patients with type 2 DM frequently exhibit a residual risk for cardiovascular disease; therefore, additional treatment options that use mechanisms of action that differ from those of statins are needed. New agents such as ezetimibe, along with the more traditional treatments of statins, fibrates, and nicotinic acid, may potentially improve the lipid profiles of patients with diabetic dyslipidemia.

Advanced glycation of apolipoprotein A-I impairs its anti-atherogenic properties

AGE contribute to the pathogenesis of diabetic complications, including dyslipidaemia and atherosclerosis. However, the precise mechanisms remain to be established. In the present study, we examined whether AGE modification of apolipoprotein A-I (apoA-I) affects its functionality, thus altering its cardioprotective profile. The ability of AGE-modified apoA-I to facilitate cholesterol and phospholipid efflux, stabilise ATP-binding cassette transporter A1 (ABCA1) and inhibit expression of adhesion molecules in human macrophages and monocytes was studied. The ability of AGE-modified apoA-I to promote cholesterol efflux from THP-1 macrophages, isolated human monocytes and from ABCA1-transfected HeLa cells was significantly reduced (>70%) compared with unmodified apoA-I. This effect was reversed by preventing AGE formation with aminoguanidine or reversing AGE modification using the cross-link breaker alagebrium chloride. AGE-modification of HDL also reduced its capacity to promote cholesterol efflux. AGE-apoA-I was also less effective than apoA-I in stabilising ABCA1 in THP-1 cells as well as in inhibiting expression of CD11b in human monocytes. AGE modification of apoA-I considerably impairs its cardioprotective, antiatherogenic properties, including the ability to promote cholesterol efflux, stabilise ABCA1 and inhibit the expression of adhesion molecules. These findings provide a rationale for targeting AGE in the management of diabetic dyslipidaemia.

Management of diabetic dyslipidemia: doing the right thing

Management of diabetic dyslipidemia: doing the right thing