Letters to the Editor

In reply: How should diabetic dyslipidemia be treated?

Ting-I Lee, MD, PhD
Cleveland Clinic Journal of Medicine January 2020, 87 (1) 11; DOI: https://doi.org/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

REFERENCES

    1. Grundy SM,
    2. Stone NJ,
    3. Bailey AL,
    4. et al
    . 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA guideline on the management of blood cholesterol: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation 2019; 139(25):e1082–e1143. doi:10.1161/CIR.0000000000000625
    1. Hsueh YC,
    2. Chou CL,
    3. Lee TI
    . Diabetic dyslipidemia with eruptive xanthoma. Cleve Clin J Med 2019; 86(9):575–576. doi:10.3949/ccjm.86a.18104
    1. American Diabetes Association
    . Pharmacologic approaches to glycemic treatment: standards of medical care in diabetes—2019. Diabetes Care 2019; 42(suppl 1):S90–S102. doi:10.2337/dc19S009