Colesevelam has been suggested as a promising alternative treatment for patients with type 2 diabetes mellitus (T2DM) who are intolerant to statins or who have an elevated LDL cholesterol level despite statin treatment. In this Practice Point commentary, we discuss a randomized, controlled, double-blind trial that assessed the effect of colesevelam treatment on glycemic control in patients with T2DM that was not adequately controlled by insulin alone or by insulin and oral hypoglycemic agents. After 16 weeks, colesevelam improved glycemic control and decreased LDL cholesterol levels, but it increased triglyceride levels. The occurrence of hypoglycemia and weight gain was not affected by colesevelam treatment. The beneficial effects of colesevelam on both glucose and LDL cholesterol levels suggest that this agent provides a useful treatment option for patients with T2DM. Nevertheless, the risk of poor compliance with colesevelam treatment in clinical practice, the high treatment cost and the lack of outcome data are limitations to the wider use of this drug.
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K Tziomalos is supported by a grant from the Hellenic Atherosclerosis Society.
The authors declare no competing financial interests.
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Tziomalos, K., Athyros, V. & Mikhailidis, D. Colesevelam improves glycemic control and lipid management in inadequately controlled type 2 diabetes mellitus. Nat Rev Endocrinol 5, 16–17 (2009). https://doi.org/10.1038/ncpendmet1021