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Pharmaceutical Treatment of Hypertension and Dyslipidemia in People With Diabetes: An Educator’s Perspective

Part 2: Dyslipidemia

The first 300 words of the full text of this article appear below.

	Case Presentation

 
T.S. is a 49-year-old, divorced, African-American man who was diagnosed with type 2 diabetes 4 years ago. He works as a court stenographer and is very active in community projects.

The patient is on oral medication for his diabetes. However, his blood glucose levels remain > 200 mg/dl. His hemoglobin A_1c (A1C) results have ranged between 8 and 9% over the past year. He denies symptoms of polyuria, polyphagia, polydipsia, or nocturia. He has no complaints of fatigue, blurred vision, chest pain, dyspnea on exertion, nausea, vomiting, diarrhea, constipation, early satiety, paraesthesias in his extremities, or burning pain in his feet.

There is no family history of diabetes. The patient’s father died of myocardial infarction at age 55. His mother is alive and well.

Medications and supplements the patient uses include glyburide, 10 mg twice daily; zestril, 40 mg at bedtime; gingko; and a multivitamin.

T.S. has truncal obesity with a BMI of 39 kg/m². He lives alone, often skips breakfast, and eats most other meals out. He does not follow any kind of meal plan. Diet history reveals large portion sizes because of the frequent restaurant meals. His daily intake is 2,800 calories, of which 42% is fat, 15% is saturated fat, 15% is protein, and 43% is carbohydrate.

The patient says he is unable to do any exercise because his arthritic knees hurt him too much. He also states that he is too busy, and it is too dangerous to walk in his neighborhood because the dogs might attack him.

T.S. stopped smoking 15 years ago. Before that time, he smoked one pack of cigarettes per day for 10 years. He drinks one to two glasses of wine with dinner 5–7 days of the week.

Objective data and laboratory results:
Height: 5'8''

Weight: 258 lb

BMI: 39 kg/m²

Blood pressure: 130/80 mmHg

. . . [Full Text of this Article]

	Discussion

 
Pharmacological Therapy of Dyslipidemia
Statins
Fibrates
Bile Acid Sequestrants
Niacin
2-Azetidinone
Conclusion

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