The role of lipid-lowering therapy in preventing coronary heart disease in patients with type 2 diabetes.

Coronary heart disease is the most common cause of death among diabetic patients. The increased risk of coronary heart disease in type 2 diabetes is due, in part, to lipid abnormalities often present in the diabetic patient. Diabetic dyslipidemia is characterized by elevated triglycerides, low high-density lipoprotein cholesterol (HDL-C) and an increased preponderance of small, dense low-density lipoprotein cholesterol (LDL-C) particles. Current guidelines for the prevention of coronary heart disease in diabetic patients identify elevated LDL-C as the primary target of lipid-lowering therapy, and recommend statins as the first-line treatment for diabetic dyslipidemia. This review evaluates the large statin trials that have included diabetic patients, and discusses the role of combination therapy in managing dyslipidemia in diabetic patients.