Pharmacological treatment of lipid disorders in diabetes mellitus

Lopes‐Virella, Maria F.; Colwell, John A.

doi:10.1002/dmr.5610030305

Cited by 14 publications

(2 citation statements)

References 148 publications

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“…This apparently can be answered only by long-term prospective clinical trials. Regardless of the treatment given, once glycemic control has been achieved it is essential that any remaining lipid abnormalities be evaluated systematically and treated with diet alone or with lipid-lowering agents (73,74).…”

Section: Ia Gallowaymentioning

confidence: 99%

Treatment of NIDDM With Insulin Agonists or Substitutes

Galloway

1990

Diabetes Care

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Non-insulin-dependent diabetes mellitus (NIDDM) is a common disorder occurring in 3-6% of adults in most western populations. In the United States, 29% of patients with diabetes take insulin; of these, 76% have NIDDM. Insulin therapy is usually required at some time in NIDDM. Insulin therapy improves the abnormalities of NIDDM (reduced beta-cell function, increased hepatic glucose production, reduced peripheral glucose disposal, lipid abnormalities). Insulin and sulfonylurea agents have comparable effects on mild forms of NIDDM, but for more severe forms, insulin is usually superior. Combination insulin-sulfonylurea treatment may improve the response to sulfonylureas, although long-term well-controlled trials have not been conducted. Short-term insulin treatment may restore response to sulfonylureas. Other promising treatments (human proinsulin, nasal insulin, somatostatin) have not shown any advantage over conventional insulin therapy. Insulin causes hypoglycemia and peripheral hyperinsulinemia. The hazards of hyperinsulinemia, e.g., weight gain and hypoglycemia, have been overstated, and questions about its atherogenic effects remain to be resolved. The effect of glycemic control on macro- and microvascular complications has not been established; however, maintaining fasting blood glucose levels of less than 6.7 mM may protect against progression of retinopathy, neuropathy, and nephropathy and reduce the severity of ischemic stroke. Dosage algorithms generally use intermediate- or long-acting insulin to control basal glycemia, with regular insulin added before meals if needed to control postprandial glycemia. Effective therapy depends on the patient being informed, cooperative, and willing to self-monitor blood glucose. Insulin treatment intermittency increases the risk for immune complications (resistance and allergy). Overall, patients with NIDDM can benefit from insulin therapy.

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Section: Ia Gallowaymentioning

confidence: 99%

Treatment of NIDDM With Insulin Agonists or Substitutes

Galloway

1990

Diabetes Care

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“…Two review papers on the pharmacological treatment of lipid disturbances in diabetes mellitus have recently been published. 33,34 …”

Section: Treatment Of Hyperlipidemias In Diabetics With Drugsmentioning

confidence: 99%

Hyperlipidemia in Diabetes Mellitus:Pathogenesis, Diagnosis, and Pharmacological Therapy

Johansen

1990

Ann Saudi Med

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Lack of Awareness and Treatment of Hyperlipidemia in Type II Diabetes in a Community Survey

Stern

Patterson

Haffner

et al. 1989

JAMA

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Cardiovascular disease is the leading cause of morbidity, disability, and death among patients with type II (non-insulin-dependent) diabetes mellitus. Moreover, hyperlipidemia is also common among these patients. Despite this, there are virtually no data regarding the level of awareness and treatment of hyperlipidemia among diabetic subjects at the community level. We therefore examined 374 Mexican-Americans and 86 non-Hispanic whites with type II diabetes identified in an epidemiologic survey that involved 3279 Mexican-Americans and 1847 non-Hispanic whites who resided in San Antonio, Tex. More than 40% of the diabetic subjects were hyperlipidemic according to the criteria of the National Cholesterol Education Program, and an additional 23% had hypertriglyceridemia and/or low levels of high-density lipoprotein cholesterol. By contrast, less than one fourth of the nondiabetic subjects were hyperlipidemic. Only approximately 25% of non-Hispanic whites with diabetes were aware of their hyperlipidemia, and less than 10% were receiving treatment. Awareness and treatment were even less frequent among Mexican-Americans with diabetes. Community physicians should be encouraged to give early attention to the management of lipid disorders in their diabetic patients.

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Pharmacological treatment of lipid disorders in diabetes mellitus

Cited by 14 publications

References 148 publications

Treatment of NIDDM With Insulin Agonists or Substitutes

Treatment of NIDDM With Insulin Agonists or Substitutes

Hyperlipidemia in Diabetes Mellitus:Pathogenesis, Diagnosis, and Pharmacological Therapy

Lack of Awareness and Treatment of Hyperlipidemia in Type II Diabetes in a Community Survey

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