People with high triglyceride levels should limit daily fat calories to 10 percent of total calories. Any excess is converted into triglycerides to be stored as fat. —American Diabetes Association
Statins
This class of drugs lowers triglycerides
and LDL cholesterol by decreasing
the amount of cholesterol produced
in the liver. Evidence suggests statins
signi;cantly reduce the risk of CVD in
people with diabetes. Statins differ in
their ability to lower LDL cholesterol
levels, so doses for each medication
need to be tailored to your therapy
and how your body responds to it.
Your doctor may recommend
another drug in addition to a statin,
says Tara Dall, M.D., a lipidologist in
Dela;eld, Wisconsin. “Drugs such
as niacin and ;brates provide
additional lipid bene;ts when used
in combination with a statin,” she says.
Statins can lower triglycerides 7% 30%
Niacin High-dose nicotinic acid, a derivative
of the B vitamin niacin that’s available
by prescription, is used in high doses
to treat high triglycerides. Prescription
niacin also signi;cantly increases HDL
(good) cholesterol. So why isn’t
everyone taking it? Because high
doses bring side effects such as
;ushing, nausea, dizziness, liver
damage, and increased blood
glucose. To ;nd the right dose, niacin
treatment often starts at a low dose
and is gradually increased.
Fibric acids
Fibrates, or ;bric acids, are the drugs
of choice for the targeted treatment of
high triglycerides. They lead
to lower levels of very low density
lipoproteins (VLDLs)—a larger form
of LDL cholesterol—and triglycerides.
Fibrates help lower the amount of free
triglycerides circulating in the blood.
Fenobribrate is often favored over
gem;brozil because it’s taken once
daily and has minimal liver interaction.
Eat ;sh, such as albacore tuna nd salmon, high in omega- 3s at least twice a week in order to promote heart health. Other foods that contain high levels of omega-3s: walnuts and olive oil.
Omega- 3 fatty acids
Certain foods, such as those shown
at left, provide the most important
triglyceride-lowering omega- 3
polyunsaturated fatty acids (PUFAs)—
docosahexaenoic acid (DHA) and
eicosapentaenoic acid (EPA). Over-the-counter (OTC) supplements
deliver these fatty acids, too.
“Although many patients want to
use OTC supplements instead of
the more expensive prescription
treatment, the dosages of OTC
omega- 3 supplements are insuf;cient
to produce good results in bringing
down triglycerides,” Dall says. For very
high triglycerides, a prescription form
of PUFAs, Lovaza, may be necessary.
Gastrointestinal discomfort and ;shy
aftertaste are potential side effects
of PUFAs. Taking PUFAs with food
may minimize these side effects.
52 Diabetic Living FALL 2010
