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Medication in lipid disorders

If the blood lipid level treatment targets of a person with diabetes are not achieved through lifestyle therapy within 3–6 months, it is time to start medication.

Statin research has provided the most convincing scientific proof with regard to preventing or slowing down an existing arterial disease. Statin treatment reduces the arterial disease death rate and morbidity amongst people with diabetes. Existing atherosclerosis may be reduced when the LDL cholesterol level drops to or below 1.8 mmol/l.

In people with diabetes, arterial disease incidents drop by approximately 20 percent per a 1 mmol/l reduction in LDL cholesterol.

Usually, cholesterol medication is permanent, provided that there are no harmful side effects. The attending physician will assess the need for medication of young persons (< 40 years) on a case-by-case basis.

The lipid metabolism disorders of the metabolic syndrome and type 2 diabetes are characterised by the high triglyceride level and low HDL cholesterol level in plasma. The primary medicine is statin or a combination of statin and ezetimibe. If statin is not suitable, ezetimibe or sometimes fibrate can be considered. There is also some research evidence regarding the treatment of lipid metabolism disorder using resin or PCSK9 inhibitors and treating a high triglyceride level using an icosapent product, but these drugs are secondary. Their use can be considered on a case-by-case basis, and their reimbursability varies.

Kela grants the lower special reimbursement (65%) for lipid medication, if the person has a coronary artery disease or severe hereditary lipid metabolism disorder.

Updated 30.9.2023