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Hyperlipidaemia in diabetes: are there particular considerations for next‑generation therapies? – published online 20/02/2024

Beliard graphical abstract

Sophie Béliard, Florian Mourre, René Valéro

Dyslipidaemias are major cardiovascular risk factors, especially in people with diabetes. Over the last 10 years, a large number of next-generation therapies in the field of lipidology have been developed. In this issue, Béliard et al (https://doi.org/10.1007/s00125–024–06100-z) provide an update on these next-generation lipid-modifying therapies, with particular emphasis on their efficacy in the population with diabetes and their potential impact on glucose metabolism. Lowering LDL-cholesterol levels is usually the first goal in individuals with diabetes to reduce the risk of atherosclerotic CVD. However, the authors highlight that, beyond controlling LDL-cholesterol levels, it is necessary to improve the lipid abnormalities that are responsible for residual cardiovascular risk: elevated lipoprotein (a) levels and atherogenic dyslipidaemia. The authors describe how new drugs under development with the aim of decreasing LDL-cholesterol, triglyceride or lipoprotein (a) levels are promising to reduce the burden of CVD, particularly in those with diabetes, or reduce the risk of acute pancreatitis. These drugs have favourable, unfavourable or neutral effects on the risk of new-onset diabetes or glycaemic control. The authors conclude that further studies are needed to confirm the efficacy of these new drugs and monitor their potential side effects, particularly with regard to glycaemic control. The figure from this review is available as a downloadable slide.

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