Management of diabetic dyslipidemia: An update

Table 1 Summary of low-density lipoprotein-cholesterol lowering medications

Drug class	Mechanism of action	Clinical eficacy	Adverse reactions
Statins	Inhibition of HMG coenzyme A Reductase	Highly effective	Myalgia, myositis, rhabdomyolysis, elevation in liver enzymes, new onset diabetes
Ezetimibe	Decrease intestinal cholesterol absorption by binding to Niemann-Pick C1-like 1 protein	Moderately effective; Safe addition to statin therapy	Worsening of liver function, myopathy or rhabdomyolysis if added to statins; Nasopharyngitis, diarrhea, upper respiratory tract infection
PCSK9 inhibitors	Inhibition of Proprotein Convertase Subtilisin/Kexin Type 9	Very highly effective in combination with statin therapy	Injection site reaction including itching, swelling, erythema and pain
Bile acid sequestrants	Bind bile acids in the small intestine and prevent reabsorption	Moderately effective, safe addition to statin therapy, not desirable if triglycerides are > 300 mg/dL	Constipation, abdominal pain, bloating, drug malabsorption

HMG: Hydroxymethylglutaryl; PCSK9: Proprotein convertase subtilisin/kexin type 9.