Combination versus monotherapy with statins in patients with type 2 diabetes mellitus of high and very high cardiovascular risk

Aim. Comparison of the influence of mono- and combined lipid-lowering therapy on lipid profile and glycemia in patients with T2DM.

Methods. A comparative assessment of lipid profile dynamics in patients with type 2 diabetes from the group of high and very high risk of cardiovascular diseases depending on lipid-lowering therapy - atorvastatin in increasing doses (group 1), or by a combination of low doses of rosuvastatin and ezetimibe (group 2) was carried out.

Results. It was found that at baseline comparable lipid metabolism in the study groups, after completion of therapy in both groups there was a significant decrease in total cholesterol, low-density lipoprotein cholesterol, and triglycerides. In group 2 after completion of treatment triglyceride levels were significantly lower than in group 1. At the same time, after completion of hypolipidemic therapy course with atorvastatin, there was a significant increase in the level of both basal and postprandial glycemia, as well as glycated hemoglobin. In the group of combined therapy the level of postprandial glycemia and glycated hemoglobin after completion of the course of treatment was significantly lower than the baseline. As a result, by the end of 6 months of treatment in group 2 was significantly lower level of basal glycemia and glycated hemoglobin compared to group 1.

Conclusion. Combined lipid-lowering therapy with rosuvastatin and ezetimibe is significantly more effective than monotherapy with atorvastatin. This is expressed in a more pronounced lipid-lowering effect of this combination on the background of almost neutral effect on carbohydrate metabolism. At the same time, there was a negative effect of atorvastatin therapy on carbohydrate metabolism. The results require further research to clarify the mechanisms of this effect.

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