Diabetic dyslipidemia is characterized by elevated LDL cholesterol levels, in addition to elevated triglyceride levels and reduced HDL cholesterol levels. The most accurate indicator of a patient's cardiovascular risk lipid profile is the apolipoprotein B level.
Apart from pharmacological intervention, non-pharmacological intervention in the form of smoking cessation, regular physical activity, weight reduction plays an equally important role. Glycaemic compensation is key.
Aside from pharmacological intervention, statins are the drug of choice to reduce macrovascular complications of diabetes, where very often ezetimibe must be used in combination to achieve the recommended LDL cholesterol target. Fibrates are intended to reduce residual CV risk and reduce the number of microvascular complications of diabetes.
PCSK9 inhibitors do not (yet) have an indication for the treatment of diabetic dyslipidaemia.