Dyslipidaemia in type 2 diabetes
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Dyslipidaemia in type 2 diabetes

Maria Adiseshiah Clinical Research Sister, Department of Medicine, Jules Thorne Institute, Middlesex Hospital
Susan Olive Diabetes Specialist Nurse, University College London Hospitals Trust
Zoe Harrison Diabetes Dietician, University College London Hospitals Trust

Aims and intended learning outcomes

The aim of this article is to provide an overview of the pathophysiology of lipid metabolism in diabetes, the evidence-based associated cardiovascular risk, and the current recommendations for lifestyle change and intervention. After reading this article you should be able to:

Define the role of insulin in normal glucose and fat metabolism

Summarise the interplay of insulin resistance, glucose intolerance and obesity in creating the atherogenic lipid profile seen in diabetes

Describe assessment of dyslipidaemia and how to calculate associated cardiovascular risk

Define the role of the primary care nurse in initiating life-style change to reduce identified risk

Describe the ongoing care of individuals having treatment for dyslipidaemia.

People with type 2 diabetes are three to five times more likely to develop coronary heart disease (CHD) and are twice as likely to die from their heart disease than individuals with normal glucose tolerance (Turner et al 1998). The UK Prospective Diabetes Study (UKPDS) showed that 18 per cent of patients with type 2 diabetes had an abnormal ECG at diagnosis, 2 per cent had suffered a myocardial infarct and 3 per cent had angina pectoris (UKPDS 8 1991). The increased mortality rate among people with type 2 diabetes compared to the general population cannot be explained only by the three classic risk factors for CHD; smoking, hypertension and raised plasma cholesterol concentrations. Many of these individuals are identified in the primary care setting. A clear understanding of the risk factors that predispose to atherosclerosis disease underpins the assessment and intervention process carried out by the primary care team to mediate the risk of early or sudden death from CHD in diabetes.

Primary Health Care. 12, 1, 41-49. doi: 10.7748/phc2002.