Diabetic Dyslipidemia Management

• Diabetic dyslipidemia is characterized by hypertriglyceridemia, high levels of apoB, non-HDL-C and small-dense LDL particles.

• Moderate- to high-intensity statins remain the cornerstone for treatment of diabetic dyslipidemia based on ASCVD risk and other risk enhancers.

• Ezetimibe is now recommended as the first add-on therapy to statins because of the cost consideration. PCSK9 inhibitors are the next class of drugs added to lipid management as they have proven safety and efficacy, with expected future decreases in cost.

• Icospent ethyl holds promise in diabetic dyslipidemia as it reduces TG and improves CV outcomes; add-on to statin if TG 135-499 mg/dL.

• Combination of statins and fibrates is not routinely recommended.