Certified Diabetes Care and Education Specialist (CDCES) Practice Exam

In managing hypertriglyceridemia (TG > 500 mg/dL), which therapeutic option is considered most appropriate?

1. Garlic

2. Fenofibrate

3. Ezetimibe

4. Plant sterols

The correct answer is: Fenofibrate

Fenofibrate is recognized as the most appropriate therapeutic option for managing hypertriglyceridemia, particularly when triglyceride levels are greater than 500 mg/dL. This medication is a fibrate that works by decreasing triglyceride levels through several mechanisms, including increasing the activity of lipoprotein lipase, which enhances the breakdown of triglycerides. When triglyceride levels are elevated above this threshold, there is a significant risk of pancreatitis, making effective management crucial. Fenofibrate has been shown in clinical studies to effectively lower not only triglyceride levels but also to improve overall lipid profiles. This makes it a vital option in the treatment plan for individuals with severe hypertriglyceridemia. Other options, while beneficial in certain lipid management contexts, do not specifically target triglyceride levels as effectively as fenofibrate. Garlic, for example, may have some modest effects on lower lipid levels, but its benefits are insufficient for the management of such high triglyceride levels. Ezetimibe primarily focuses on lowering LDL cholesterol rather than triglycerides, and plant sterols are more effective in reducing cholesterol absorption rather than directly addressing high triglycerides. Thus, fenofibrate stands out as the most appropriate choice in this specific scenario.