Der Pharma Chemica
Journal for Medicinal Chemistry, Pharmaceutical Chemistry, Pharmaceutical Sciences and Computational Chemistry


Diabetes associated dyslipidemia: Management

Author(s): Ramachandran Vadivelan, Dipanjan Mandal, Umasankar Payyavulla, Dhanabal Palaniswamy, Kannan Elango and Suresh Bhojraj

By the year 2030 , it is assumed that there will be more than 300 million type 2 diabetes sufferers worldwide. Diabetes is a serious vascular disease with poor prognosis, and not only a disease characterized by elevated blood glucose . One important cardiovascular risk factor in type 2 diabetic people is dyslipidaemia. This comprises low HDL-cholesterol, high serum VLDL-triglycerides, and a preponderance of small, dense LDL. Even slight elevations of LDL-cholesterol in type 2 diabetes are associated with a substantial increase in cardiovascular risk. The composition of lipid particles in diabetic dyslipidaemia is more atherogenic than in dyslipidaemia in general. Atherosclerosis is a major complication of diabetes responsible for the increased morbidity and mortality. Lowering of LDL-cholesterol is a very attractive target of lipid modifying therapy, dyslipidaemia therapies are efficacious for both LDL-cholesterol reduction and raising HDL-cholesterol might offer more improvements in coronary heart disease in type 2 diabetic people. Statins are first-line pharmacotherapy for dyslipidaemia and can also improve HDL-cholesterol levels. Combining a fibrate or niacin with statin therapy raises HDL-cholesterol more than a statin alone but might be associated with reduced tolerability and increased adverse reactions. Several new therapeutic approaches to raising HDL-cholesterol are in development, including an HDL mimetic and inhibitors of cholesteryl ester transfer protein. Dyslipidaemia therapies are efficacious for both LDLcholesterol reduction and raising HDL-cholesterol might offer further improvements in coronary heart disease (CHD) risk reduction.