Type 2 diabetes is frequently associated with dyslipidaemia characterized by elevated triglycerides, reduced high-density lipoprotein cholesterol (HDL-C), and a preponderance of small, dense low-density lipoprotein cholesterol (LDL-C) particles. These lipid abnormalities contribute to an increased risk of atherosclerotic cardiovascular disease (ASCVD). The pathophysiological mechanisms underlying this enhanced risk include enhanced oxidative stress, inflammation and endothelial dysfunction, all of which are aggravated by hyperglycaemia.
With so much attention being placed upon the diverse and meritorious benefits arising from use of medications such as the GLP-1 receptor agonists and the SGLT-2 inhibitors in people with diabetes, is lowering cholesterol still meaningful in people with type 2 diabetes?
Evidence seems to suggest that non-LDL lipoproteins, such as triglyceride-rich lipoproteins and lipoprotein(a), also play significant roles in the residual cardiovascular risk observed in people with diabetes. We will cover this aspect of clinical care in our August Journal Club.
