[Hyperlipidemia in diabetes mellitus. Pathogenesis, diagnosis and drug therapy--a review]

Atherosclerosis is the most prevalent long-term diabetic complication. The increased mortality and morbidity in diabetics caused by atherosclerosis has been related to the frequent occurrence of hyperlipidaemia in diabetes. Insulin regulates many processes in lipid metabolism via control of enzyme activity and receptor binding. It is important to establish a precise diagnosis of the lipid abnormalities before commencing treatment. The treatment begins with control of blood glucose, followed by dietary treatment of hyperlipidaemia. Hypolipidaemic drugs are first introduced when the dietary response is unsatisfactory. Optimal therapy with antidiabetic drugs should precede hypolipidaemic drug therapy.