Diabetes Metab J.  2011 Apr;35(2):101-106. 10.4093/dmj.2011.35.2.101.

The Causes and Consequences of Low Levels of High Density Lipoproteins in Patients with Diabetes

• Barter PJ

• KMID: 2281707
• DOI: http://doi.org/10.4093/dmj.2011.35.2.101

Abstract

Type 2 diabetes is commonly accompanied by a low level of high density lipoprotein cholesterol (HDL-C) that contributes to the increased cardiovascular risk associated with this condition. Given that HDLs have the ability to improve increase the uptake of glucose by skeletal muscle and to stimulate the secretion of insulin from pancreatic beta cells the possibility arises that a low HDL concentration in type 2 diabetes may also contribute to a worsening of diabetic control. Thus, there is a double case for raising the level of HDL-C in patients with type 2 diabetes: to reduce cardiovascular risk and to improve glycemic control. Approaches to raising HDL-C include lifestyle factors such as weight reduction, increased physical activity and stopping smoking. Of currently available drugs, the most effective is niacin. Newer formulations of niacin are reasonably well tolerated and have the ability to increase HDL-C by up to 30%. The effect of niacin on cardiovascular events in type 2 diabetes is currently being tested in a large-scale clinical outcome trial.

Keyword

Diabetes mellitus, type 2; High density lipoprotein; Insulin secretion; Insulin resistance; Lifestyle

MeSH Terms

Cholesterol
Cholesterol, HDL
Diabetes Mellitus, Type 2
Glucose
Humans
Insulin
Insulin Resistance
Insulin-Secreting Cells
Life Style
Lipoproteins
Lipoproteins, HDL
Motor Activity
Muscle, Skeletal
Niacin
Smoke
Smoking
Weight Loss
Cholesterol
Cholesterol, HDL
Glucose
Insulin
Lipoproteins
Lipoproteins, HDL
Niacin
Smoke