Treatment of lipids and type 2 diabetes

Heart disease is one of the major risks associated with type 2 diabetes and lowering of lipid level in the blood through drugs or lifestyle changes is desirable. The dangers of death and disability due to heart problems can be significantly reduced if cholesterol is controlled. Statin therapy has proved that major coronary events and expensive revascularization procedures can be reduced and the incidence of strokes brought down. The advantages of this treatment are irrespective of the cholesterol level at the beginning of the treatment. Patients of both genders and from all age groups have shown positive results irrespective of the presence of vascular disease.

Forceful lipid lowering in patients with intensive statin therapy or high dose of statin therapy has proved more beneficial than standard dose or standard statin therapy. Greater reductions in C reactive protein and LDL were achieved due to intensive statin therapy. Slowing down or reversing the progression of atherosclerotic conditions is also possible with this type of therapy. Experts believe that high dose of statins lowers LDL more aggressively. However, it must be noted that this study has only shown that atherosclerotic conditions can be reversed or slowed down but not heart disease. Some experts think that when greater amount of LDL is reduced the risk of heart disease and strokes is definitely reduced.

Healthy lifestyle cannot be replaced by cholesterol reducing medications. The choice of a correct lipid lowering medication is an important part of the treatment. The patient’s blood lipid profile generally should dictate which medications have to be used to raise or lower specific lipids in a blood. For patients requiring a lowering of LDL statins are considered standard drugs. Bile-acid binding drugs along with statins should be considered when the desired goals of lowering LDL are not achieved. Patients who require the lowering of triglycerides and increase of HDL, niacin has proved beneficial. However, The American Heart Association recommends that in case of obese and overweight treatment lifestyle changes should be first tried before the administration of drugs to treat and reduce lipid levels. Statins are the best drugs for patients with diabetes who also have to reduce cholesterol as they reduce or eliminate the risk of heart events. Even people with mild or normal cholesterol level benefit from statin treatment. Niacin is by far the most effective drug, however, it is a bit difficult to tolerate as it has a tendency to increase blood sugar levels.

The American Heart Association recommends that statins should be the first line of treatment for lowering cholesterol in children and adolescents with a family history of heart attacks, high cholesterol, and stroke along with diabetes.