Diabetes and Lipids: A Review and Update on Lipid Biomarkers and Cardiovascular Risk

Objective

To review existing and new evidence regarding the relationship between diabetes and dyslipidemia and to provide an update of the lipid biomarkers used to assess cardiovascular risk and the current guidelines reflecting these changes.

Methods

We conducted a literature review pertaining to diabetes and lipids using the MEDLINE/PubMed database. We reviewed articles in English and primarily published between 1994 and early 2025. Also included are guidelines published by professional organizations who are recognized nationally or internationally in the fields of diabetes, lipids, and cardiovascular disease.

Results

Studies evaluating the relationship between diabetes and hypertriglyceridemia have provided practice-changing evidence. Lipid markers such as apolipoprotein B, non–high-density lipoprotein cholesterol, and lipoprotein (a), as well as the concept of lipid variability have emerged as treatment targets.

Conclusion

Over the past 30 years, non–low-density lipoprotein cholesterol lipid markers have been identified to further stratify individuals with diabetes who are at risk for future cardiovascular events. Treatment targets and pharmacological therapy have been studied and continue to be updated.