Diabetes mellitus is a high-risk factor for atherosclerotic disease. Dyslipidaemia has a high prevalence among diabetics and behaves in a more atherogenic manner with high levels of triglycerides and small dense LDL particles in addition to low HDL. An early approach is imperative. Statins are the first choice and are highly effective. When association is necessary or in cases of intolerance ezetimibe is the first option and/or PCSK9 inhibitors, in addition to fibrates for hypertriglyceridaemia. There are promising new drugs such as bempedoic acid, icosapent ethyl, inclisiran, and some novel antidiabetic drugs. Cardiovascular risk may be underestimated in diabetes, and statins can decrease it significantly.
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