[Molecular mechanism of action of ezetimibe and recent therapeutics]

High blood Low density lipoprotein cholesterol is a major cardiovascular risk factor and must be the primary target of primary and secondary heart protection. Statines, 3-hydroxy-3-methylglutaryl-coenzyme A [HMG-CoA] reductase inhibitors, are the cornerstone of lipid-lowering therapy for reducing LDLc levels. However, some patients at high risk fail to achieve LDLc target despite high-dose statin therapy. Statins may also induce adverse effects. Ezetimibe is the first potent cholesterol absorption inhibitor. Several ongoing clinical interventional trials will shed more light on the association statin plus ezetimibe in high risk patients. A better understanding of intestinal cholesterol absorption will lead to novel approaches for the prevention and treatment of hyperlipidemia

Microvascular complications in the type 2 diabetes: impact of the insulin therapy

When oral antidiabetics at optimal dosage have failed to maintain good diabetic control, insulin treatment has to be considered. The aim of this retrospective study is to evaluate over a 5 years period the incidence of progression in microvascular complications in 35 type 2 diabetes patients treated with insulin and compared to 35 controls treated with oral hypoglycemic agents. By 3-5 years, the "insulin" group had lower risks of progression in both complications: retinopathy [p=0,005] and neuropathy [p<0,05]. However, the incidence of progression in nephropathy was quite similar between the two groups. Our study confirms the long term results found in the literature about effects of insulin therapy on microvascular complications in diabetic patients