Treatment Guideline for Dyslipidemia in Diabetes Mellitus / 임상당뇨병

ABSTRACT

The recently published 2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults published by the American Heart Association (AHA) and American College of Cardiology (ACC) changes the treatment paradigm for high cholesterol. Based on a systematic review of randomized controlled clinical trials (RCTs), the new guideline no longer targets LDL cholesterol (LDL-C) level but focuses on treating cholesterol to reduce atherosclerotic cardiovascular disease (ASCVD) risk. Only data from RCTs of cholesterol-lowering drug therapies with cardiovascular outcomes or meta-analyses of these RCTs were considered. In Type 2 diabetes in those 40~75 years of age with risk factors, the potential benefits of LDL-C reduction with a high-intensity statin are substantial. Because those with diabetes often have a lower LDL-C level than those without diabetes, "goal"-directed therapy often encourages use of a lower statin dose than is supported by the RCTs, and non-statin drugs may be included to address low HDL-C or high triglycerides, for which there is little RCT evidence of an ASCVD event reduction.