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Diabetes and Dislipidemia

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Book cover Diabetes Complications, Comorbidities and Related Disorders

Part of the book series: Endocrinology ((ENDOCR))

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Abstract

Diabetes mellitus is associated with significant increases in ASCVD. In T1DM, increased ASCVD is linked to hyperglycemia, renal disease, and hypertension, with dyslipidemia contributing when present. In T2DM, although the aforementioned complications of diabetes may each contribute to increased ASCVD, the dyslipidemia plays a more important role. Optimal glycemic control with diabetes medications can normalize plasma lipid levels in most individuals with T1DM. Insulin resistance is central to the pathophysiology of dyslipidemia in T2DM, with obesity and independently inherited detrimental lipid genes exacerbating the phenotype. Aggressive LDL lowering is key in individuals with T2DM because of their very high risk for ASCVD. High doses of potent statins are the first line of therapy followed by ezetimibe, which will be required to achieve LDL cholesterol levels well below 100 mg/dl. Therapy with lifestyle, and if needed, TG-lowering agents such as fibrates and omega-3 fatty acid concentrates can be used to treat hypertriglyceridemia, with the understanding that these agents have not consistently reduced ASCVD events. When individuals with T2DM also have very high levels of LDL

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Authors and Affiliations

  1. Department of Medicine, Irving Institute for Clinical and Translational Research, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA

    Henry N. Ginsberg

  2. Department of Medicine, Bassett Medical Center, New York, NY, USA

    Maryam Khavandi

  3. Department of Medicine, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA

    Gissette Reyes-Soffer

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  1. Henry N. Ginsberg
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  2. Maryam Khavandi
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  3. Gissette Reyes-Soffer
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Correspondence to Henry N. Ginsberg .

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Editors and Affiliations

  1. Division of Endocrinology, Diabetes and Metabolism, University and Hospital Trust of Verona, Verona, Italy

    Enzo Bonora

  2. Diabetes Division, Diabetes Research Unit, University of Texas Health Science Center, San Antonio, TX, USA

    Ralph A. DeFronzo

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Ginsberg, H.N., Khavandi, M., Reyes-Soffer, G. (2018). Diabetes and Dislipidemia. In: Bonora, E., DeFronzo, R. (eds) Diabetes Complications, Comorbidities and Related Disorders. Endocrinology. Springer, Cham. https://doi.org/10.1007/978-3-319-44433-8_2

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