The dyslipidemia of diabetes mellitus: Giving triglycerides and high-density lipoprotein cholesterol a higher priority?

Most excess mortality associated with diabetes mellitus results from cardiovascular diseases, several risk factors of which are modifiable in diabetes mellitus patients, including dyslipidemia characterized by increased levels of triglycerides (TGs), reduced high-density lipoprotein cholesterol (HDL-C) levels, and smaller, denser, more atherogenic low-density lipoprotein cholesterol (LDL-C) particles. Lipid management focuses on reduction of LDL-C, with low levels of HDL-C or high TGs receiving less attention. Given the prevalence of this "dyslipidemia of diabetes," therapeutic lifestyle changes and glucose control along with targeted drug therapy must be considered. Emerging evidence and continuing clinical trials suggest that treatment of lipid disorders beyond those of LDL-C may be necessary to significantly reduce cardiovascular risk in the diabetes mellitus population.