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Is there a link between diabetes and cholesterol metabolism?

Type 2 diabetes mellitus (DM) is characterized by increased glucose plasma levels.[1] Worldwide, 1 in 16 (6.3%) adults were affected with DM in 2010 and it is estimated that the prevalence will rise to 7.7% in 2030, affecting more than 438 million people.[2] Long-term complications of type 2 DM are neuropathy, retinopathy, nephropathy and macrovascular complications such as myocardial infarction. Although it is clear that the increased glucose levels arise from impaired pancreatic insulin secretion combined with decreased peripheral insulin sensitivity, the pathophysiologic basis of these entities is not completely understood. A role for cholesterol metabolism is suggested, based on the association between statin use and new onset type 2 DM.[3] In addition, we recently showed that the prevalence of type 2 DM is decreased in patients with familial hypercholesterolemia (FH),[4] further supporting the role for cholesterol metabolism in the development of type 2 DM. In this editorial, we discuss the possible link between type 2 DM and cholesterol metabolism.