Erfolge der Lipidsenkung bei Patienten mit Diabetes mellitus

Zusammenfassung

Patienten mit Diabetes mellitus gelten als Hochrisikopatienten für kardiovaskuläre Ereignisse. Nur wenige Studien mit Lipidsenkern haben gezielt Diabetiker untersucht, so dass meist nur Subgruppenanalysen aus den großen Interventionsstudien vorliegen. Diabetiker profitieren von einer Therapie mit Statinen, unabhängig vom Ausgangswert des LDL-Cholesterins. Neue Daten sprechen dafür, dass möglichst niedrige LDL-Zielwerte angestrebt werden sollen. Die Lipidsenkung mit Fibraten ist in Bezug auf eine Verbesserung von Endpunkten (Morbidität, Mortalität) nicht in demselben Maße gesichert wie bei den Statinen. Deshalb kann für Fibrate bei Diabetikern keine allgemeine Empfehlung ausgesprochen werden.

Summary

Patients with diabetes mellitus are patients at high risk for cardiovascular events. There is only limited number of studies examining the effects of lipid lowering specifically in diabetics. The majority of evidence is derived from subgroup analyses of large intervention trials. Patients with diabetes mellitus benefit from a therapy with statins, independently from the starting LDL cholesterol concentrations. Furthermore, recent studies strongly suggest that for high risk patients such as diabetics regarding LDL „the lower is the better” The data for the benefits of fibrate therapy is not as robust as those available for statins. Therefore, at present no specific recommendation for treatment of diabetics with fibrates can be made.

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