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Approach to Dyslipidemia Among Diabetic Patients
Approach to Dyslipidemia Among Diabetic Patients
Farzad Hadaegh, MD
Prevention of Metabolic Disorders Research Center
Research Institute for Endocrine Sciences
Shahid Beheshti University of Medical Sciences
Tehran, Oct 2019
Agenda
- Overview of dyslipidemia among Tehranian diabetic population
- Definition and pathophysiology of diabetic dyslipidemia
- Statin therapy in diabetic patients
- Residual risk and add on statin therapy(ezetimibe , highly purified
omega 3 and PCSK9 inhibotors) in individuals with diabetes mellitus
- Guideline (ADA/2019, AHA/2019, 2019 ESC/EAS)
- Take home message
Case Scenario
A 58-year-old obese male patient with type 2 diabetes mellitus (T2DM) presents with a history of ACS and previous CABG 2 years earlier. His HbA1C value has been stable at 7.2% with metformin and liraglutide 1.8 mg daily.
He is currently normotensive with Lozartan/HCT 50 mg/12.5 mg with a urine/albumin creatinine ratio at 80 mg/mg and an eGFR of 48 ml/min.
The patient’s current lipid profile with rosuvastatin 40 mg and ezetimibe 10 mgdaily is as follows: (LDL-C), 66 mg/dl; (TGs), 320 mg/dl; (HDL-C), 38 mg/dl; and non– HDL-C, 130 mg/dl.
The patient and his primary care physician are concerned about his residual risk of recurrent ASCVD events and his overall prognosis. What is your recommendation for the patient?
