T2DM with Diabetic Dyslipidemia

Just wanted to share the reports with you all Male patient with Diabetes Mellitus and Hypertension Kindly give your views on lipid profile of patient? What is best to give him - Statins + fenofibrate or Statins only How about saroglitazar? When to use it? @@Sepuri Krishna Mohan Need your valuable opinion sir




Dear Dr Ajeet Singh, As from the reports you had posted we can come to a conclusion that the patient is suffering from 1) Uncontrolled T2DM 2) Dyslipidemia, Uncontrolled Triglycerides, abnormally elevated TG Should R/O Familial Hypertriglycedemia. It so happens that Uncontrolled T2DM is associated with increased TG levels. So controlling blood sugar levels with Basal Bolus Insulin Regimen meticulously as per the recommendations of ADA, if HbA1c is more than 9%, it's an indication for Insulin Therapy. Usually when one achieves Euglycemia TG levels go down accordingly. Whereas in this case it's abnormal TG elevation may lead to Acute Pancreatitis so Pharmacological therapy should be started along with Diet and Exercise. It's a clearcut indication for Tab Saroglitazar 4 mg once daily along with Statins like Atorvastatin or Rosuvastatin. Such cases require additional investigations like FPG 2hr PG Urinary Ketones and blood Ketones. RFT LFT ECG TFT Serum Amylase Serum Lypase. Always make it a point to mention Height Weight BMI. Regards and thanks, Dr Sepuri Krishna Mohan

Sir, what time of day to give saroglitazar and rosuvastatin? Bedtime is best?? Or 15 mins before dinner?

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This is serious start right away with insulin as recommendation is hba1c above 9 ...start insulin to control and triglycerides are higher bcz high blood sugars cause fat breakdown releasing triglycerides so basically high bd sugar is responsible for this...monitor progress through weight gain after insulin start....

Yes necessary to control hba1c first as it is quite high so as average mean bsl Better option is to put on insulin once diabetes is in control review lipid profiles And control tg i feel statin+fenofibrate is sufficient As pt can be called in followup and we can review our plan

Thanx dr Vedprakash Sharma

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Strat insulin for the treatment of diabetes. Use statin plus fenofibrate. Do USG whole abdomen to look for any pancreatitis as patient is having very high triglycerides. And repeat fasting lipid profile ..??? LDL is very low.

U can use lipaglyn but then insulin dose should be calculated accordingly as it also improves insulin resistance

Saroglitazar is potential drug controling diabetes as well as hyper triglycerides & cholesterol

4 mg od if stating fails to control

Ldl 13 only start fenofibirate 200 mg of of with Omega 3 fatty acid do one tsh profile


Star HIR, and then finofibrate & omega 3

I agree

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Uncontrolled DM All lipid factors, especially, TGL , will be abnormal in this condition. Quick control of blood sugar with insulin will bring down most lipid abnormalities. Statins are mandatory. Lipid assay can be repeated after blood sugar control , and addition of fenofibrate can be considered if TGL is still high . If both LDL and TGL are high , Lipaglyn( Saroglitazar ) has demonstrable benefits in DM2.

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