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Diabetes and heart disease: a new strategy for managing lipid disorders.

Dyslipidemias represent an underdiagnosed and undertreated clinical problem in the management of diabetic patients. Glycemic control by itself is not sufficient to correct elevated triglycerides and low HDL levels, which greatly increase the risk of cardiovascular disease. Careful monitoring and aggressive intervention can dramatically reduce the risk that these dyslipidemias pose in diabetic and prediabetic patients. Weight loss by obese patients, low-fat diets, and gradually increased aerobic exercise should be tried for 6 months. If lipid levels are still outside the acceptable range, consider adding lipid-lowering drug therapy. Age should be no barrier to intervention, as coronary risk factors continue to contribute to the incidence of events into advanced age.