The basis for treatment of
lipid disorders in patients with
non-insulin-dependent diabetes mellitus is
weight reduction by diet and exercise, and additional control of glycaemic condition with oral
antidiabetics, alone or in combination with
insulin. Hypercholesterolaemic, mildly hypertriglyceridaemic
non-insulin-dependent diabetes mellitus patients respond to
cholesterol malabsorption caused by dietary
sitostanol ester margarine, while long-term
statin treatment of respective coronary patients significantly lowers the recurrence of coronary events, in addition to improving the
lipid disorder. However, no information is available concerning the preventive effect of long-term improvement of
lipid disorders in
non-insulin-dependent diabetes mellitus patients without
coronary heart disease, or in patients with the 'classical' type of diabetic
lipid disorder, that is, hypertriglyceridaemia with low HDL and normal-low
LDL-cholesterol levels. In this group of patients, beneficial
lipid effects can be obtained (although perhaps not normalization) with
fibrates alone or, especially, in combination with current
statins.