Improving glycemic and cholesterol control through an integrated approach incorporating colesevelam - A clinical perspective

Research output: Contribution to journalReview article

2 Scopus citations

Abstract

Bile sequestrants have been used for almost 50 years to lower low density lipoprotein cholesterol (LDL-C). The advent of colesevelam in 2000 provided a more tolerable add-on LDL-C-lowering agent with an excellent safety record and with likely benefit for coronary heart disease events. Colesevelam lowers LDL-C approximately 15%, and has an additive effect when combined with statin or non-statin lipid-modifying agents. It also tends to increase triglyceride levels. The discovery that bile sequestrants also lower glucose levels led to definitive large-scale clinical trials testing the effect of colesevelam as a dual antihyperglycemic agent with LDL-C-lowering properties in type 2 diabetic subjects on metformin-, sulfonylurea- or insulin-based therapy with inadequate glycemic control. Colesevelam was found to lower hemoglobin A1c (HbA1c) by approximately 0.5% compared to placebo over the 16- to 26-week period, and had similar effects on the lipid profile in these diabetic subjects, as had previously been demonstrated in non-diabetic individuals. Colesevelam was well tolerated, with constipation being the most common adverse effect, and did not cause weight gain or excessive hypoglycemia. Colesevelam thus combines antihyperglycemic action with LDL-C-lowering properties, and should be useful in the management of type 2 diabetes.

Original languageEnglish (US)
Pages (from-to)11-21
Number of pages11
JournalDiabetes, Metabolic Syndrome and Obesity: Targets and Therapy
Volume2
DOIs
StatePublished - 2009

Keywords

  • Colesevelam
  • Hyperglycemia
  • LDL-cholesterol
  • Treatment

ASJC Scopus subject areas

  • Pharmacology
  • Internal Medicine

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