Type 2 Diabetes Adult Outpatient Insulin Guidelines - CMA Foundation

Pharmacotherapy for Dyslipidemia 23
To reach optimal lipid levels, most patients will require lipid modifying medications combined
with Therapeutic Lifestyle Changes (TLC). While reducing serum LDL cholesterol is the primary
target of treatment in clinical lipid management, some people may also benefit from therapies
to lower triglycerides and/ or increase HDL cholesterol levels. Some individuals will require
combined drug therapies to reach target treatment goals that result in a reduction of LDL
cholesterol levels and, when advisable, raise HDL cholesterol levels.
Statins, also known as HMG-CoA reductase inhibitors, are currently considered the most
effective, practical, and commonly prescribed class of drugs that target reducing LDL
cholesterol levels. The statins are generally well tolerated by most people and have a lower risk
of adverse side effects and/or risk of drug to drug interactions.
In some cases, drug therapies may need to be tailored to address specific dyslipidemias,
including very high LDL cholesterol, elevated serum triglycerides, low HDL cholesterol and
atherogenic dyslipidemia in persons with type 2 diabetes. Consideration should also be given
to prescribing drug therapies that target both lipid and non-lipid causes of metabolic syndrome
and insulin resistance.
There are several classes of lipid modifying and LDL lowering medications available to treat
dyslipidemia, including:
• Statins (HMG-CoA reductase inhibitors)
• Cholesterol absorption inhibitors
• Niacin (nicotinic acid)
• Fibric acid derivatives
• Bile acid sequestrants
• Combination drugs
Currently only nicotinic acid (niacin) has been approved for over the counter (OTC) use. The
following table lists commonly used dyslipidemia treatment medications.
CMA FoundAtion . diAbetes And CArdiovAsCulAr diseAse Provider reFerenCe guide . july 2011 47
Comprehensive
management of
type 2 diabetes