Dyslipidaemia in Diabetes

Description

Monitoring 

Medicine Treatment 

Referral

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ICD-10 Code: E78.0-6/E78.8-9

DESCRIPTION

• Dyslipidaemia in type 2 diabetes is usually characterised by increased fasting plasma triglycerides (>1.7 mmol/L), decreased HDL cholesterol (<1.0 mmol/L in men and <1.30 mmol/L in women) and to a lesser extent, increased LDL cholesterol 
• In those with type 1 diabetes, triglycerides, and to a lesser extent cholesterol concentrations, are usually increased

MONITORING

• See: Type 2 Diabetes Mellitus, in Adults

MEDICINE TREATMENT

Dyslipidaemia may successfully be treated through lifestyle modifications alone.

• HMGCoA reductase inhibitor (statin) therapy should be added to lifestyle modifications, regardless of baseline lipid concentrations, for all type 2 diabetic patients, who:
  • Are >40 years of age
  • Have had diabetes for >10 years
  • Have existing cardiovascular disease (for example angina pectoris, previous myocardial infarction, peripheral disease or stroke)
  • Have chronic kidney disease (eGFR <60 mL/minute)
• e.g. Simvastatin, oral, 10 mg at night

LoE:I¹⁸²

In patients <40 years of age, risk assess as for dyslipidaemia; patients on protease inhibitors or amlodipine, see: Prevention of ischaemic heart disease and atherosclerosis.

REFERRAL

• Random cholesterol >7.5 mmol/L
• Fasting (14 hours) triglycerides >10 mmol/L

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Standard Treatment Guidelines and Essential Medicines List for South Africa, Primary Healthcare Level, 2024 Edition