A 46-year-old man of European descent was reviewed in the diabetes clinic. He had type 2 diabetes mellitus, which had been diagnosed 6 months previously. He had been symptom free and was a non-smoker but had a family history of cardiovascular disease. He exercised regularly and had managed to lose 8 kg.
On examination, his blood pressure was 148/76 mmHg, his weight was 76 kg and his body mass index was 24 kg/m2 (18C25).
Investigations:
urinary albumin:creatinine ratio0.6 mg/mmol (<2.5)
serum cholesterol5.6 mmol/L (<5.2)
serum HDL cholesterol0.90 mmol/L (>1.55)
fasting serum triglycerides2.20 mmol/L (0.45C1.69)
According to NICE guidelines (CG181, July 2014), what is the most appropriate management of his lipid profile?
A . assess cardiovascular risk using UKPDS risk engine
B . observe and repeat lipid profile in a few months
C . start a fibrate
D . start a statin
E . start nicotinic acid
Answer: D
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