African-Americans suffering from diabetes should add lipid-lowering drugs to their regimen, according to a study reported by members of a research consortium in Atlanta, Georgia.
Diabetes can be a major risk factor for cardiovascular disease, and both are highly prevalent within the African-American population.
The study by the US Centers for Disease Control and Prevention, Emory University School of Medicine, Mercer University and Grady Health System showed that weight loss and improved glycemic control can lead to desirable changes in high-density lipoprotein (HDL) cholesterol and triglyceride levels. However, they do not reduce levels of so-called bad cholesterol, or low-density lipoprotein (LDL) cholesterol.
Investigators used statistical analyses to weigh the effects of weight loss, glycemic control, and lipid-specific medications on cholesterol and triglyceride levels after a year of diabetes management in the study participants. Ninety-one percent of the patients were African-American, and 95% had type 2 diabetes.
After a year, glycemic control was better, based on measurements for HbA1c, and on average all cholesterol and triglyceride levels had changed among the study group members.
However, patients who had not been prescribed lipid-lowering therapies during the previous year continued to have similar average levels of total cholesterol, LDL cholesterol, and triglycerides as they had when pre-study testing was performed. In the 102 patients who did receive lipid-specific medication, lipid levels were lower after a year.
"Mean HDL cholesterol increased regardless of lipid treatment status," said Diane M. Erdman, a pharmacist and researcher at Grady Health System in Atlanta. Of the major forms of cholesterol, HDL cholesterol is considered a beneficial form of fat.
All three of the diabetes management variables - lipid-specific drugs, weight loss and improved glycemic control - had independent effects on reduced triglyceride levels, Erdman and colleagues reported, whereas none of those factors were determined to independently affect HDL cholesterol.
"Among urban African-Americans, diabetes management led to favourable change in HDL cholesterol and triglyceride levels, but improved glycemic control and weight loss had no independent effect on LDL cholesterol concentration," the team decided.
They suggested that for African-Americans, lipid-specific drugs should be prescribed when diabetes management programmes are initiated so that patients can reduce their risks for developing cardiovascular disease.