[Lipid management--treatment goal and strategy]

Diabetic macroangiopathy is known to increase with complicated hyperlipidemia. Large clinical studies indicate that statins are effective in reducing cardiovascular events in subjects with type 2 diabetes. Target goal for LDL cholesterol in type 2 diabetes is less than 100 mg/dl in the United States, whereas it is less than 120mg/dl in Japan. Aggressive lipid-lowering therapy is indicated for type 2 diabetes, especially those with high risk. Other effects than deceasing LDL of statins, i.e. pleiotropic actions, are suggested to contribute to reduction of cardiovascular events. A decrease in HDL cholesterol and an increase in triglycerides are also risk factors for cardiovascular events, but some portion of them are attributed to dyslipidemia associated with insulin resistance.