Diabetes Newsletter - July 2018

www.berkshirewestccg.nhs.uk/diabetes July 2018
Monthly diabetes news for healthcare professionals and
others in Berkshire West
Lipid testing guidelines in diabetics 2018

Non HDL-cholesterol is the sum of all the cholesterol contained in lipoproteins which are known to contribute to atherosclerosis (narrowing of arteries).  Non HDL-cholesterol includes the cholesterol carried by low density lipoprotein (LDL-cholesterol) and very low density lipoprotein (VLDL-cholesterol).  It is thought to be a better risk predictor for cardiovascular disease compared to LDL-cholesterol alone, and is particularly beneficial for patients with type 2 diabetes.  It is also thought to be better for monitoring responses to treatments. It can be calculated by a simple subtraction (total cholesterol minus HDL-cholesterol). 

There is no need to fast for the test, and therefore it is more convenient for patients and clinicians alike.  LDL-cholesterol cannot be directly measured, requires a fasting test and is then calculated using a complicated equation.

Both NICE and JBS3 recommend measuring total cholesterol and HDL- cholesterol to achieve the best estimate of cardiovascular risk.  Because total cholesterol and HDL-cholesterol are largely unaffected by recent dietary intake, they do not require a fasting test. 

Non HDL- cholesterol can be calculated by a simple calculation: (Total cholesterol minus HDL- cholesterol).  Before starting lipid lowering medication, both guidelines recommend taking a full lipid profile which includes measuring triglycerides level. 
NICE are not offering a treatment target, but advise treatment if 10 year risk is >10%
Dr Ian Gallen
Consultant Physician Royal Berkshire FT and Community Diabetes Specialist, Berkshire West CCG. Phone: 07717867448
Diabetes Specialist Nurse Hotline: 07879 814922 (Monday to Friday 10am – 4pm) Consultant Hotline: 07717 867448. Email: virtualdiabetes@royalberkshire.nhs.uk
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