It is relatively common for diabetes to be complicated by hyperlipidemia, especially in older patients. Hyperlipidemia can lead to serious consequences such as stroke and myocardial infarction, so if hyperlipidemia is discovered, it should be treated as soon as possible. So, what kind of medicine is good for diabetics with high blood lipids? Let me explain the relevant knowledge to you in detail.

Types of lipid-lowering drugs

1. Statins

Statins are trimethylglutaryl coenzyme A***H MG-CoA ***Reductase inhibitors, also known as cholesterol biosynthetic enzyme inhibitors, are rate-limiting enzymes for intracellular cholesterol synthesis and are currently the most widely used type of lipid-lowering drugs in clinical practice. Since the English names of these drugs all contain "statin", they are often referred to as statins for short.

There are now 5 kinds of statins available for clinical use:

***1***, atorvastatin***atorvastatin***, the common drugs are Pfizer's Lipitor, Ale;

***2***, lovastatin***lovastatin***, common drugs include Mejiangzhi, Luohuaning, Lote, Lovastat, etc. , the main ingredient of Xuezhikang is also lovastatin;

***3***, simvastatin***simvastatin***, common drugs are Shujiangzhi, Risuda, Jingbi Shuxin, Zezhihao, Suzhi, Xinke, etc.;

***4***, pravastatin***pravastatin***, commonly used drugs include Pragu and Mebale Town;

***5***, fluvastatin***fluvastatin***, common drugs are available.

The most common adverse reactions of this type of drug are mild gastrointestinal reactions and headache. Myotoxicity may occur when combined with other lipid-lowering drugs.

2. Fibrates

The main indications of fibrates are: hypertriglyceridemia or mixed hyperlipidemia dominated by elevated triglycerides. disease. The fibrate drugs currently in clinical use mainly include ciprofibrate, bezafibrate, fenofibrate and gemfibrozil. According to clinical practice, these drugs can effectively reduce triglycerides by 22% to 43%, while reducing TC by only 6% to 15%, and have the effect of increasing high-density lipoprotein to varying degrees. Common adverse reactions of this drug are gastrointestinal reactions, nausea, diarrhea, and severe cases can lead to liver damage.

3. Niacin

Niacin drugs are B vitamins. When the dosage exceeds the dosage of vitamins, they can have obvious lipid-lowering effects. This type of drug has a wide scope of application and can be used for any type of hyperlipidemia except homozygous familial hypercholesterolemia and type I hyperlipoproteinemia. However, the immediate-release preparation of this drug has serious side effects, so we generally do not use it alone. The medical community is still not very clear about the lipid-lowering mechanism of niacin. Sustained-release preparations are greatly reduced, mainly facial flushing.

4. Bile acid sequestrants

This type of drug is also called bile acid sequestering agent. There is Cholestyramine***Cholestyramine***, and commonly used drugs include Jianchenning. Common adverse reactions of this drug are gastrointestinal reactions, nausea, constipation or diarrhea, intestinal obstruction or headache.

5. Cholesterol absorption inhibitors

These drugs mainly achieve the purpose of lowering blood lipids by inhibiting the absorption of cholesterol in the intestinal diet and bile. Currently, few drugs of this type are on the market.

In addition, fish oil drugs such as Duoxikang, Xuezhikang, deep-sea fish oil and other drugs also have a certain effect on lowering blood lipids.

Treatment methods for diabetes and hyperlipidemia

1. Control blood sugar

For hyperlipidemia caused by diabetes, we must first control blood sugar levels and keep blood sugar at a stable level. level. For older patients, fasting blood sugar should be reduced to at least 7.0mmol/L, and postprandial blood sugar should be reduced to less than 10.0mmol/L; for younger patients, it should be reduced to a lower range. Strictly avoid using glucose, sucrose and other sugar products. It is best to eat a light diet every day, eat coarse rice, eat more green leafy vegetables, whole grains and local foods with sugar content. Blood sugar concentration should be measured every day, and medication should be used if necessary. control.

2. Reduce blood lipids

The most important low-density lipoprotein should be reduced to less than 2.6mmol/L; when diabetes is well controlled, blood lipids may return directly to normal values. If the general treatment effect is not good, you need to use some blood lipid-lowering drugs. Nowadays, vitamin B drugs are more commonly used, such as niacin, 0.2g each time, 3 times a day, orally after meals, and then gradually increase to 1 ~2g/day, but niacin also has certain side effects, such as itching and gastrointestinal reactions. If patients with uncontrolled diabetes should not use it, it is best to use drugs such as simvastatin.

3. Lower blood pressure

Patients over 75 years old should not lower their blood pressure too low, generally no more than 150/90mmHg; those under 75 years old should at least lower it to below 140/90mmHg ; If combined with diabetic nephropathy, manifesting as large amounts of proteinuria, the blood pressure should be lowered to a lower level, preferably no more than 125/75mmHg.