Hyperlipidemia is a relatively common problem in patients with poorly controlled diabetes mellitus. It has been estimated that the frequency of elevated plasma lipid levels in diabetic patients is between 20 and 90 per cent, depending on the degree of diabetic control and the type of diabetes. Diabetics as a group tend to have higher plasma lipid levels than nondiabetics, and this abnormality is exaggerated in patients with 'poor' diabetic control. There are several reasons for this association. First, insulin plays an important role in the regulation of intermediary lipid metabolism, and fluctuations in the degree of diabetic control thus produce variable effects on plasma lipoprotein metabolism. Secondly, many non-insulin-dependent (Type 2) diabetic patients are obese, and obesity may lead to the development of hyperlipidemia. Third, although diabetes and hyperlipidemia represent different genetic disorders, each of these disorders is common in the population, and the two disorders may co-exist by chance in the same individual.
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