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Dyslipidemia

Dyslipidemia in a diabetic patient

I would like to comment on treatment of dyslipidemia in the diabetic patient with total cholesterol 195 mg/dL, HDL 32 mg/dL, LDL 98 mg/dL, and triglycerides 195 mg/dL (Item 120-8). According to my calculations, the patient’s LDL should be 124. It’s important to know, however, whether the HDL was measured by the older indirect method…

Dietary causes of high triglycerides?

Are triglyceride levels related to ingestion of fat or carbohydrates? Which diet is best for lowering triglycerides?—Colleen Root, MD, Fishers, Ind. The specific diet recommended for patients with hypertriglyceridemia depends on the underlying cause and the triglyceride level. Patients with elevated triglyceride levels should avoid diets high in simple carbohydrates, especially those containing fructose (e.g.,…

Lipid levels in a diabetic

A diabetic patient with hemoglobin A1c 6.5%, total cholesterol 195 mg/dL, HDL 32 mg/dL, LDL 98 mg/dL, and triglycerides 195 mg/dL takes atorvastatin (Lipitor) 20 mg daily. Should I try to bring down the triglycerides to <150 while “raising” the HDL a bit? The patient is on seven medications for comorbid conditions. Are omega-3-acid ethyl…

Nonfasting vs. fasting cholesterol goals

What are the recommended goals for nonfasting cholesterol levels? Since we spend most of our life in a nonfasting state, shouldn’t we be more concerned about nonfasting levels than we are about fasting ones?—Bradley Hope, MD, Santa Barbara, Calif. Since total serum cholesterol levels vary very little from the fasting to the nonfasting state, it…

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