pp 1–7 | Cite as

Diabetes and lipid metabolism

  • Vasilios G. Athyros
  • Michael Doumas
  • Konstantinos P. Imprialos
  • Konstantinos Stavropoulos
  • Eleni Georgianou
  • Alexandra Katsimardou
  • Asterios Karagiannis
Review Article


The authors review the association between diabetes mellitus (DM) and aberrations of lipid metabolism related to DM, diabetic dyslipidemia (DD). DM is considered as a major health burden worldwide and one of the most important modifiable cardiovascular disease (CVD) risk factors. This applies to both the developed and the developing countries, especially the latter. While patients with type 1 DM, 10% of all DM cases, usually do not have dyslipidemia, DD is frequent among patients with type 2 DM (T2DM) (prevalence > 75%) and is mainly a mixed dyslipidemia [increase in triglycerides (TGs), low high-density lipoprotein cholesterol (HDL-C), and small-dense (atherogenic), low-density lipoprotein cholesterol (LDL-C) particles]. The components of DD, which is characterized by quantitative (mentioned above), qualitative, and kinetic abnormalities all contributing to CVD risk, are mostly related to insulin resistance. Statins, ezetimibe, and PCSK9 inhibitors can be used in monotherapy or consecutively in combinations if needed. Statins compose the main drug. For the residual CVD risk after statin treatment, the use of statin-fibrate combinations is indicated only in patients with mixed dyslipidemia. In conclusion, DD is a major health problem worldwide. It is a significant CVD risk factor and should be treated according to current guidelines. The means today exist to normalize all quantitative, qualitative, and kinetic aberrations of DD, thereby reducing CVD risk.


Diabetes mellitus Lipid metabolism Diabetic dyslipidemia Epidemiology Pathophysiology Treatment Residual cardiovascular risk 


Compliance with ethical standards

Conflict of interest

VGA has given talks, attended conferences, and participated in trials sponsored by MSD, Sanofi, and Amgen. MD has given talks and attended conferences sponsored by Menarini, WinMedica, Bayer, Boehringer-Ingelheim, Merck, and Unipharma. AK has given talks, attended conferences, and participated in trials sponsored by WinMedica. The rest have no conflict of interest whatsoever.


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Copyright information

© Hellenic Endocrine Society 2018

Authors and Affiliations

  • Vasilios G. Athyros
    • 1
    • 2
  • Michael Doumas
    • 3
  • Konstantinos P. Imprialos
    • 1
  • Konstantinos Stavropoulos
    • 1
  • Eleni Georgianou
    • 1
  • Alexandra Katsimardou
    • 1
  • Asterios Karagiannis
    • 1
  1. 1.Second Propedeutic Department of Internal Medicine, Hippocration HospitalAristotle UniversityThessalonikiGreece
  2. 2.2nd Propedeutic Department of Internal Medicine, Medical SchoolAristotle UniversityThessalonikiGreece
  3. 3.Veteran Affairs Medical CenterGeorge Washington UniversityWashingtonUSA

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