Advanced Search

Journal Navigation

Journal Home

Subscriptions

Archive

Contact Us

Table of Contents

Sign In to gain access to subscriptions and/or personal tools.
The British Journal of Diabetes & Vascular Disease
This Article
Right arrow Abstract Freely available
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Add to Saved Citations
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Request Reprints
Right arrow Add to My Marked Citations
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Right arrow Citing Articles via Scopus
Google Scholar
Right arrow Articles by Ballinger, P.
Right arrow Search for Related Content
Social Bookmarking
 Add to CiteULike   Add to Complore   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Reddit   Add to Technorati   Add to Twitter  
What's this?

Do all diabetic patients need statins? A view from primary care

Paul Ballinger

Hednesford Street Surgery, 60 Hednesford Street, Cannock, Staffs, WS11 1DJ, UK, pballin440{at}aol.com

A majority of type 2 diabetic patients now receive routine care from their General Practitioner. The biggest single cause of mortality amongst such patients is ischaemic heart disease; diabetes is now considered to be of equivalent risk to a previous myocardial infarction in non-diabetic individuals. Most type 2 diabetic patients have the insulin resistance syndrome, and accelerated atheromatous disease at the time of diagnosis. The current guidelines on lipid management fail to recognise the unique dyslipidaemia of diabetes, and tend to undertreat the disease. There is a powerful case for all type 2 diabetic patients to receive treatment with a statin at the time of diagnosis.

Key Words: statins • lipids • type 2 diabetes.

References

  • Pierce M., Agarwal G., Ridout D. A survey of diabetes care in general practice in England and Wales. Br J Gen Prac 2000;50:542-5.[Web of Science][Medline] [Order article via Infotrieve]
  • Ramsay LE, Williams B., Johnson GD et al. Guidelines for management of hypertension: report of the third working party of the British Hypertension Society. J Hum Hypertens 1999;13:569-92.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • British Cardiac Society, British Hyperlipidaemia Association, British Hypertension Society, British Diabetic Association. Joint British recommendations on prevention of coronary heart disease in clinical practice. Heart 1998;80(suppl 2):S1-29.[Free Full Text]
  • Winocour PH Effective diabetes care: a need for realistic targets. BMJ 2002;324:1577-80.[Free Full Text]
  • American Diabetes Association. Management of dyslipidemia in adults with diabetes. Diabetes Care 2000;23(suppl 1);S57-S60.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Bierman EL George Lyman Duff Memorial Lecture. Atherogenesis in diabetes. Arterioscler Thromb 1992;12:647-56.[Free Full Text]
  • UK Prospective Diabetes Study (UKPDS) group. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet 1998;352:837-53.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Turner RC, Millns H., Neil HA et al. Risk factors for coronary artery disease in non-insulin dependent diabetes mellitus. (UKPDS 23). BMJ 1998;316: 823-8.[Abstract/Free Full Text]
  • Haffner SM, Lehton S., Ronnemaa T. et al. Mortality from coronary heart disease in subjects with type 2 diabetes and in non diabetic subjects with and without prior myocardial infarction. N Engl J Med 1998;339:229-34.[Abstract/Free Full Text]
  • Malmberg K., Yusuf S., Gerstein HC et al. Impact of diabetes on long-term prognosis in patients with unstable angina and non Q wave myocardial infarction; results of the OASIS registry. Circulation 2000;102:1014-19.[Abstract/Free Full Text]
  • Evans JM, Wang J., Morris AD Comparison of cardiovascular risk between patients with type 2 diabetes and those who had had a myocardial infarction: cross sectional and cohort studies. BMJ 2002;324:939-42.[Abstract/Free Full Text]
  • Miettinen H., Lehto S., Salomaa V. et al. Impact of diabetes on mortality after the first myocardial infarction. The FINMONICA Myocardial Infarction Register Study Group. Diabetes Care 1998;21:69-75.[Abstract]
  • Isomaa B., Almgren P., Tuomi T. et al. Cardiovascular morbidity and mortality associated with the metabolic syndrome. Diabetes Care 2001;24: 683-9.[Abstract/Free Full Text]
  • Haffner SM, Mykannen L., Festa A. et al. Insulin-resistant prediabetic subjects have more atherogenic risk factors than insulin-sensitive prediabetic subjects: implications for preventing coronary heart disease during the prediabetic state. Circulation 2000;101:975-80.[Abstract/Free Full Text]
  • Harpaz D., Gottlieb S., Graff E. et al. Effects of insulin treatment on survival in non-insulin dependent patients with coronary disease. Israeli Bezafibrate Infarction Prevention Study Group. Am J Med 1998;105:494-9.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Koskinen P., Manttari M., Manninen V. et al. Coronary heart disease incidence in NIDDM patients in the Helsinki Heart Study. Diabetes Care 1992;15:820-5.[Abstract]
  • Rubins HB, Robins SJ, Collins D. et al. Gemfibrozil for the secondary prevention of coronary heart disease in men with low levels of high density lipoprotein cholesterol. N Engl J Med 1999;341:410-18.[Abstract/Free Full Text]
  • Diabetes Atherosclerosis Intervention Study investigators. Effect of fenofibrate on progression of coronary artery disease in diabetes. Lancet 2001;357:905-10.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Elkeles RS, Diamond JR, Poulter C. et al. A double-blind placebo controlled study of bezafibrate: the St Mary's, Ealing, Northwick Park Diabetes Cardiovascular Disease Prevention (SENDCAP) study. Diabetes Care 1998;21:641-8.[Abstract]
  • Pyorala K., Pedersen TR, Kjekshus J. et al. Cholesterol lowering with Simvastatin improves prognosis of diabetic patients with coronary heart disease. A subgroup analysis of the Scandinavian Simvastatin Survival Study. Diabetes Care 1997;20:614-20.[Abstract]
  • Hoogwerf BJ, Waness A., Cressman M. et al. Effects of aggressive cholesterol lowering and low-dose anticoagulation on clinical and angiographic outcomes in patients with diabetes: the Post Coronary Artery Bypass Graft Trial. Diabetes 1999;48:1289-94.[Abstract]
  • Heart Protection Study Collaborative group. MRC/BHF Heart Protection Study of cholesterol lowering with simvastatin in 20,536 high-risk individuals: a randomised placebo-controlled trial. Lancet 2002;360:7-22.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Executive summary of The Third Report of The National Cholesterol Education Programme (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA 2001;285:2486-97.[Free Full Text]

The British Journal of Diabetes & Vascular Disease, Vol. 3, No. 1, 58-61 (2003)
DOI: 10.1177/14746514030030011001


Add to CiteULike CiteULike   Add to Complore Complore   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to Technorati Technorati   Add to Twitter Twitter    What's this?


This article has been cited by other articles:


Home page
British Journal of Diabetes & Vascular DiseaseHome page
Y. Samarasinghe, M. Al-Mrayat, M. Vloemans, and N. Munro
NICE guidelines for management of lipids in type 2 diabetes mellitus: a practical interpretation
The British Journal of Diabetes & Vascular Disease, May 1, 2003; 3(3): 222 - 225.
[PDF]


This Article
Right arrow Abstract Freely available
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Add to Saved Citations
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Request Reprints
Right arrow Add to My Marked Citations
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Right arrow Citing Articles via Scopus
Google Scholar
Right arrow Articles by Ballinger, P.
Right arrow Search for Related Content
Social Bookmarking
 Add to CiteULike   Add to Complore   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Reddit   Add to Technorati   Add to Twitter  
What's this?