Detailed cholesterol testing for Type 2 diabetes patients is the focus of a newly published article by Atherotech Diagnostics Lab Chief Medical Officer Michael E. Cobble, M.D. "Advanced Lipid Testing" appears in the September/October 2010 quarterly issue of Practical Diabetology.
The article discusses the clinical advantages of advanced cholesterol testing in reducing cardiovascular disease (CVD) risk in patients with Type 2 diabetes and details several currently available advanced lipid tests, including the VAP® Cholesterol Test from Atherotech. Cobble also explores which patients are appropriate to test and how to apply advanced lipid testing results.
Advanced lipid testing is affordable, widely available and may provide valuable information in the treatment and management of people living with Type 2 diabetes, explained Cobble, who is also a director, researcher and clinician at Canyons Medical Center in Sandy, Utah.
"We know that aggressive management of multiple cardiovascular disease risks in diabetes mellitus patients has proven beneficial," Cobble said. "But in order to properly treat these patients, we first must identify them and effectively assess their risk. This is achieved through advanced lipid profiles."
Diabetes is a high-risk CVD condition that affects more than 24 million Americans, and patients with Type 2 diabetes are considered high risk due to traditional CVD risk factors and residual lipid risk factors, all of which can be determined through detailed lipoprotein assays such as the VAP Test.
"Standard lipid tests miss more than half of all at-risk patients, and may actually underestimate the number of lipoprotein particles that can lead to atherosclerotic plaques," Cobble said. "When it comes to diabetic patients, the standard test simply doesn't give us enough data to make the best decisions for our patients."
Advanced lipid tests provide a more sophisticated measurement of LDL, HDL, VLDL, non-HDL and other lipid subcomponents. The Vertical Auto Profile (VAP), for example, reports the relative distribution of cholesterol content of all lipoproteins and subfractions — 22 components of blood cholesterol to be exact — at no additional cost.
The VAP Test includes Lp(a) and reports all three lipoprotein parameters — LDL, non-HDL and apoB — considered necessary by the expert consensus guidelines issued by the American Diabetes Association and American College of Cardiology. Unlike the standard lipid profile, the VAP Test directly measures LDL and is therefore unaffected by triglycerides, allowing the test to be performed in non-fasting patients. The VAP Test reports all lipoproteins and apolipoproteins, including apoA1 and the apoB/apoA1 ratio, and it can identify triglyceride remnant markers for Metabolic Syndrome, a precursor and coexistor to diabetes.
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