DYSLIPOPROTEINEMIA AND DIABETES

Dyslipidemia in patients with diabetes constitutes quantitative and qu alitative abnormalities in all classes of lipoproteins and may be a si gnificant contributor to the high risk of atherosclerosis in these pat ients. A step-care approach to therapy of diabetic dyslipidemia, inclu ding hygienic measures (diet and increased physical activity), hypogly cemic drugs, and lipid-lowering drugs, is recommended. The choice of l ipid-lowering drugs depends on severity of hypertriglyceridemia. Stati ns and bile-acid-binding resins are the choice of therapy for diabetic dyslipidemia; however, for severely hypertriglyceridemic patients, fi bric acid derivatives should be used. Nicotinic acid worsens hyperglyc emia and, therefore, should be avoided. The value of estrogen replacem ent therapy in postmenopausal women with diabetes has not been establi shed.