[KoK! Health] For Diabetes Patients... Manage 'Dyslipidemia' Faster, Lower, and More Aggressively

Vascular stock photo. [Image source=Pixabay]

[Asia Economy Reporter Lee Gwan-joo] Dyslipidemia refers to a condition where the total cholesterol in the blood, low-density lipoprotein (LDL) cholesterol?which is the bad cholesterol that causes atherosclerosis?and triglycerides increase, or high-density lipoprotein (HDL) cholesterol?the good cholesterol that prevents atherosclerosis?decreases. Among these, when LDL cholesterol is high, it is called hypercholesterolemia; when triglycerides are high, it is called hypertriglyceridemia; and when HDL cholesterol decreases along with these, it is collectively referred to as dyslipidemia. Dyslipidemia is a state where lipid components are excessive in the blood, and these lipid components accumulate on the blood vessel walls and cause inflammation, potentially leading to cardiovascular diseases such as angina or myocardial infarction, thus requiring special attention.

The causes are diverse but can be broadly divided into primary causes caused by specific genetic mutations and secondary causes related to obesity, alcohol consumption, high-carbohydrate and high-fat diets, thyroid, kidney, liver dysfunction, and type 2 diabetes. Hypertriglyceridemia is closely related to obesity, alcohol consumption, type 2 diabetes, and unhealthy eating patterns, which are problematic in modern society. Low HDL cholesterol is known to be caused by genetic predisposition, obesity, and smoking. Dyslipidemia is defined as a total cholesterol level of 240 mg/dL or higher, LDL cholesterol of 160 mg/dL or higher, triglyceride level of 200 mg/dL or higher, and HDL cholesterol below 40 mg/dL for men and below 50 mg/dL for women.

According to the 'Fact Sheet 2022' by the Korean Society of Lipid and Atherosclerosis, the prevalence of dyslipidemia among adults aged 20 and older is approximately 40%. In particular, the comorbidity rates with chronic diseases known as modern illnesses such as diabetes, hypertension, and obesity show dyslipidemia in 87% of diabetic patients, 72% of hypertensive patients, and 53.7% of obese patients with a body mass index (BMI) of 25 or higher.

Among these, the most important comorbid condition is diabetes. Diabetes itself causes various vascular problems. High blood glucose can cause issues in multiple coronary arteries at once, often recurs even after treatment, and has a lower survival rate compared to non-diabetics. Additionally, diabetes raises triglyceride and LDL cholesterol levels and lowers HDL cholesterol, worsening dyslipidemia.

Professor Hwang Yu-cheol of the Department of Endocrinology and Metabolism at Kangdong Kyung Hee University Hospital is explaining dyslipidemia.
[Photo by Kangdong Kyung Hee University Hospital]

For diabetic patients, an LDL cholesterol level exceeding 100 mg/dL is diagnosed as dyslipidemia requiring specialist treatment. Even if LDL cholesterol is not high, an increase in very low-density lipoprotein (VLDL) cholesterol makes atherosclerosis more likely to develop. Therefore, diabetic patients need to take a more proactive approach to the treatment and management of dyslipidemia. Professor Hwang Yoo-chul of the Department of Endocrinology and Metabolism at Kangdong Kyung Hee University Hospital explained, "For diabetic patients, lowering LDL cholesterol?the main goal in managing dyslipidemia?is important through medication," adding, "there may be limitations in reaching target levels through exercise and dietary control alone." In particular, Professor Hwang emphasized, "At the same lipid levels, diabetic patients have a much higher risk of cardiovascular disease compared to non-diabetics," and "treatment should be earlier, more aggressive, and aimed at lower lipid targets."

If a diabetic patient does not have cardiovascular disease, HDL cholesterol should be controlled below 100 mg/dL. However, if there is cardiovascular disease, chronic kidney disease, hypertension, smoking, coronary artery disease, or a family history, it is recommended to control the level below 70 mg/dL. Professor Hwang stated, "Managing dyslipidemia and hyperlipidemia in diabetic patients is very important not only for current quality of life but also for preventing and managing future complications," and "I strongly urge patients to undergo integrated management of blood sugar, blood pressure, lipids, and lifestyle habits together with specialized medical staff."

This content was produced with the assistance of AI translation services.