Letters to the Editor

How should diabetic dyslipidemia be treated?

Taher Modarressi, MD
Cleveland Clinic Journal of Medicine January 2020, 87 (1) 11; DOI: https://doi.org/10.3949/ccjm.87c.01003

TO THE EDITOR: The case presented by Hsueh and colleagues1 is interesting and illustrative. The options for fibric acid derivatives are equally listed as gemfibrozil and fenofibrate. It should be noted, however, that current multisociety guidelines recommend statin treatment for most patients with diabetes,2 and fenofibrate is the preferred fibric acid derivative to use in combination with a statin. Gemfibrozil has been associated with a higher risk of muscle-related toxicity when combined with statin therapy due to inhibitory effects on the statin metabolic pathway and subsequent increases in plasma statin concentrations.3 US Food and Drug Administration labeling includes this precaution and states that the benefits of combination use of gemfibrozil and statins do not outweigh the risks.

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