In reply: How should diabetic dyslipidemia be treated?

Ting-I Lee

doi:10.3949/ccjm.87c.01004

We agree that statin therapy is first-line treatment for primary prevention of atherosclerotic cardiovascular disease for patients with diabetes mellitus who are 40 to 75 years of age.¹ However, severe hypertriglyceridemia (fasting triglycerides ≥ 500 mg/dL and especially > 1,000 mg/dL) in diabetic patients, such as our patient,² may warrant pharmacologic therapy with fibric acid derivatives, fish oil, or both to reduce the risk of acute pancreatitis.³ Thus, lifestyle modifications, glycemic control with oral hypoglycemic agents, and fenofibrate therapy were initially prescribed to our patient.²

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