Since patients with diabetes have the main source of energy as fats, or proteins, so, lipid lowering medication may cause some problem for them. It may not be advisable to prescribe any of such drugs to diabetes patients.
Dear Ali,
Check these papers out:
Efficacy of lipid lowering drug treatment for diabetic and non-diabetic patients: metaanalysis of randomised controlled trials. João Costa et al. BMJ 2006;332:1115
Results Twelve studies were included. Lipid lowering drug treatment was found to be at least as effective in diabetic patients as in non-diabetic patients. In primary prevention, the risk reduction for major coronary events was 21% (95% confidence interval 11% to 30%; P < 0.0001) in diabetic patients and 23% (12% to 33%; P = 0.0003) in non-diabetic patients. In secondary prevention, the corresponding risk reductions were 21% (10% to 31%; P = 0.0005) and 23% (19% to 26%; P ≤ 0.00001). However, the absolute risk difference was three times higher in secondary prevention. When results were adjusted for baseline risk, diabetic patients benefited more in both primary and secondary prevention. Blood lipids were reduced to a similar degree in both groups.
Conclusions The evidence that lipid lowering drug treatment (especially statins) significantly reduce cardiovascular risk in diabetic and non-diabetic patients is strong and suggests that diabetic patients benefit more, in both primary and secondary prevention.
Cholesterol Lowering With Simvastatin Improves Prognosis of Diabetic Patients With Coronary Heart Disease: A subgroup analysis of the Scandinavian Simvastatin Survival Study (4S)
K Pyörälä et al.
RESULTS Over the 5.4-year median follow-up period, simvastatin treatment produced mean changes in serum lipids in diabetic patients similar to those observed in nondiabetic patients. The relative risks (RRs) of main endpoints in simvastatin-treated diabetic patients were as follows: total mortality 0.57 (95% CI, 0.30–1.08; P = 0.087), major CHD events 0.45 (95% CI, 0.27–0.74; P = 0.002), and any atherosclerotic event 0.63 (95% CI, 0.43–0.92; P = 0.018). The corresponding RRs in nondiabetic patients were the following: 0.71 (95% CI, 0.58–0.87; P = 0.001), 0.68 (95% CI, 0.60–0.77; P < 0.0001), and 0.74 (95% CI, 0.68–0.82; P < 0.0001).
CONCLUSIONS The results strongly suggest that cholesterol lowering with simvastatin improves the prognosis of diabetic patients with CHD. The absolute clinical benefit achieved by cholesterol lowering may be greater in diabetic than in nondiabetic patients with CHD because diabetic patients have a higher absolute risk of recurrent CHD events and other atherosclerotic events.
Dear Ali,
Check these papers out:
Efficacy of lipid lowering drug treatment for diabetic and non-diabetic patients: metaanalysis of randomised controlled trials. João Costa et al. BMJ 2006;332:1115
Results Twelve studies were included. Lipid lowering drug treatment was found to be at least as effective in diabetic patients as in non-diabetic patients. In primary prevention, the risk reduction for major coronary events was 21% (95% confidence interval 11% to 30%; P < 0.0001) in diabetic patients and 23% (12% to 33%; P = 0.0003) in non-diabetic patients. In secondary prevention, the corresponding risk reductions were 21% (10% to 31%; P = 0.0005) and 23% (19% to 26%; P ≤ 0.00001). However, the absolute risk difference was three times higher in secondary prevention. When results were adjusted for baseline risk, diabetic patients benefited more in both primary and secondary prevention. Blood lipids were reduced to a similar degree in both groups.
Conclusions The evidence that lipid lowering drug treatment (especially statins) significantly reduce cardiovascular risk in diabetic and non-diabetic patients is strong and suggests that diabetic patients benefit more, in both primary and secondary prevention.
Cholesterol Lowering With Simvastatin Improves Prognosis of Diabetic Patients With Coronary Heart Disease: A subgroup analysis of the Scandinavian Simvastatin Survival Study (4S)
K Pyörälä et al.
RESULTS Over the 5.4-year median follow-up period, simvastatin treatment produced mean changes in serum lipids in diabetic patients similar to those observed in nondiabetic patients. The relative risks (RRs) of main endpoints in simvastatin-treated diabetic patients were as follows: total mortality 0.57 (95% CI, 0.30–1.08; P = 0.087), major CHD events 0.45 (95% CI, 0.27–0.74; P = 0.002), and any atherosclerotic event 0.63 (95% CI, 0.43–0.92; P = 0.018). The corresponding RRs in nondiabetic patients were the following: 0.71 (95% CI, 0.58–0.87; P = 0.001), 0.68 (95% CI, 0.60–0.77; P < 0.0001), and 0.74 (95% CI, 0.68–0.82; P < 0.0001).
CONCLUSIONS The results strongly suggest that cholesterol lowering with simvastatin improves the prognosis of diabetic patients with CHD. The absolute clinical benefit achieved by cholesterol lowering may be greater in diabetic than in nondiabetic patients with CHD because diabetic patients have a higher absolute risk of recurrent CHD events and other atherosclerotic events.
diabetics generally have dyslipidemia and in case of type2 DM usually are associated with obesity and the efficacy of these may not be more than 20-40%.Hence newer strategies are being tried to develop either drugs which inhibit POLIPOROTEIN SYNTHESIS or MTP inhibitors WHICH all are in phase 2 trials or specific microrna s to improve function eg MIr 155 aaffects the LIVER functional enzymes to prevent development of staeatotohepatitis and and is helpful in improving insulin sensitivity as well ,besides mi R 145 which helps in both obesity as well as used in treating coronary artery restenosis in diabetics when stents stop functioning
http://www.ncbi.nlm.nih.gov/pubmed/23509227
http://www.ncbi.nlm.nih.gov/pubmed/25008143
http://www.ncbi.nlm.nih.gov/pubmed/23991091
lipid lowering drugs can improve the prognosis of type 2 diabetes for sure but its efficacy in type 1 diabetes is yet to be proven. The article by João Costa et al. 2006 did differentiate the drug effects in both type 1 and type 2 diabetes.
Lipid lowering drugs should be of more beneficial importance to diabetics just for the importance in cardiovascular diseases.
First step: Treat diabetes type 2 patients with anidiabetic agents to achieve a good control condition. If you observe that in the first step you do not achieve a normal lipoprotein profile, follow the excelent guide from the above answers
i agree with dr regin wilkinski that once you have a good diabetic control automatically the lipoprotein profile should return to normal and one shouldnt be needing any lipid lowering drugs and need only arises with uncontrolled DM OR IN DEFAULTERS .
I'm concerned about the kind of questions and answers posed here. I'm expecting this is a network of scientists and not a blog for patients-to-patient-to-supposed experts chatting. Questions should be specific and prevalently based on technical issues. There are no snapshot answers for generic questions like that raised here, which should be rather directed to the personal doctor On the other hand people not expert in the field should avoid to release their says and concatenate endless nonsense discussions. Just a question to Ali: did you raise the question as a patient because you are considering to take lipid lowering drugs or as a scientist for thirst of knowledge? In the first instance I respond to you as a doctor: don't ask these question over the internet. To whom of the colleagues who responded do you intend to follow? I suggest to trust you doctor. In the second case I reply as a scientist: go trough the scientific literature. Pubmed is plenty of studies, Beatrice has given a shot, that can get you expert in the field.
I would suggest that you perform a more thorough bibliographic research on glucose and fatty acid metabolism in diabetes and insulin resistance.
Have in mind also that the metabolism of glucose and lipids may not be directly related to lipidemic profile.
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