**6. Conclusion**

*Management of Dyslipidemia*

**ADA**

more. **ESC/EASD**

**CDS**

**JDS**

**Table 2.**

<2.6 mmol/L).

lipid-lowering therapy.

of coronary artery disease.

50% is recommended.

least 50% is recommended.

**Target Statin treatment**

factors, it may be reasonable to initiate statin therapy in addition to lifestyle therapy.

risk factors or aged 50–70 years, it is reasonable to use high-intensity statin therapy.

intensity statin therapy in addition to lifestyle therapy.

In patients with T2D at moderate CV risk, an LDL-C target of <2.6 mmol/L (<100 mg/dL) is recommended.

In patients with T2D at high CV risk, an LDL-C target of <1.8 mmol/L (<70 mg/dL) and LDL-C reduction of at least

In patients with T2D at very high CV risk, an LDL-C target of <1.4 mmol/L (<55 mg/dL) and LDL-C reduction of at

The primary goal is to reduce LDL-C to the target (very high risk of ASCVD: <1.8 mmol/L, high risk of ASCVD:

LDL-C reduction by ≥50% may be used as an alternative target in the event of high baseline LDL-C and failure to reduce LDL-C to the target after 3 months of standard

The primary goal of antidyslipidemic therapy is to control the LDL-C level to <120 mg/dL in patients without a history

The control goal for fasting triglyceride (TG) is <150 mg/dL.

*Guidelines for the management of diabetic dyslipidemia using statin.*

The control goal for HDL-C is ≥40 mg/dL.

For patients with diabetes aged 40–75 years without atherosclerotic cardiovascular disease, use moderate-

In patients with diabetes at higher risk, especially those with multiple atherosclerotic cardiovascular disease

In adults with diabetes and a 10-year atherosclerotic cardiovascular disease risk of 20% or higher, it may be reasonable to add ezetimibe to maximally tolerated statin therapy to reduce LDL cholesterol levels by 50% or

> Statins are recommended as the first-choice lipid-lowering treatment in patients with DM and high LDL-C levels: administration of statins is defined based on the CV risk profile of the patient and the recommended LDL-C (or non-HDL-C) target levels.

Statins are the preferred lipid-lowering drugs. Lipid-lowering therapy should start with a moderate-intensity statin, and the dose should be adjusted according to individual response to medication and

Statins are the agents of choice for hyper-LDL-C in patients with diabetes.

tolerability.

For patients with diabetes aged 20–39 years with additional atherosclerotic cardiovascular disease risk

**44**

independent of baseline cholesterol [47].

for both primary and secondary CVD prevention among diabetes. The detailed guideline are listed according to age groups: for 20–39 years-old diabetic patients with atherosclerotic cardiovascular disease risk factors, statin therapy is highly recommended in addition to lifestyle therapy; for patients with diabetes aged 40–75 years without atherosclerotic cardiovascular disease, use moderate-intensity statin therapy (lowers LDL by 30–49%) in addition to lifestyle therapy; while for patients aged 50–70 years with diabetes, high-intensity statin therapy (lowers LDL by ≥50%) is recommended [8]. The 2013 ACC/AHA guideline emphasized statin therapy recommended for all patients with diabetes 40 to 75 years of age-

Despite the CVD protective effect among diabetic patients, statin therapy has been associated with new-onset T2DM [31, 32]. A former study reported that for every 40 mmol/L reduction of LDL by statins, conversion to T2DM is increased by 10% [48, 49]. Nevertheless, the benefits in terms of cardiovascular event reduction

Complex lipoprotein metabolism abnormalities could present both in the development and progression of type 2 diabetes, which indicates that lipid management can prevent cardiovascular complications among diabetic patients and involve in the prevention of diabetes. Epidemiological studies suggest that lipid components could be a marker for diabetes prediction, though it is still uncertain which lipid markers are of the most clinical value. Lipid control using a lipid-lowering medication, such as statins, could reduce CVD risk among the general population also diabetic people. However, it is necessary to consider statin diabetogenicity in clinical practice when the statin is indicated.
