Lipid management in patients with diabetes mellitus.

The prevalence of diabetes mellitus has been increasing dramatically in recent decades. This trend closely follows the marked increase in the prevalence of obesity in the United States. As the proportion of the population with diabetes increases, the need for prevention and therapy to reduce cardiovascular events in these patients becomes critically important. Although plasma glucose control is important in reducing microvascular complications due to diabetes, lipid management is essential in these patients to reduce the incidence of cardiovascular events. Adult patients with type 2 diabetes, in the absence of known coronary artery disease (CAD), have a similar 10-year risk for cardiac events as do patients without diabetes with established coronary disease. Recent clinical trials have highlighted the importance of aggressive plasma lipid lowering for both the primary and secondary prevention of atherosclerotic events in patients with diabetes. The likelihood of an ever-increasing diabetic patient population requires new systematic approaches to prevention as well as therapy for these patients and further development of a team approach by the medical community to optimize care despite limited resources.