In poorly controlled Type 1 DM with coexistent hypertriglyceridaemia, as already mentioned, good metabolic control of the blood sugar with insulin therapy usually also restores the triglycerides level to normal.
In Type 2 DM - where obesity and insulin resistance usually coexist -weight loss with diet and physical activity constitute the cornerstone of treatment. It is remarkable, however, that although weight loss and better metabolic control of DM with antidiabetic pills or insulin usually improve the dyslipidaemia, they do not completely restore it to normal levels. The reduction of the particularly elevated cardiovascular risk of these diabetic individuals requires the multifactorial and simultaneous confrontation of all risk factors that are related to the metabolic syndrome (glycaemia, hypertension, obesity and dyslipidaemia) and also the cessation of smoking. Although blood sugar control per se, when the other elements of the metabolic syndrome coexist, does not appear to decrease - at least to the expected degree - the risk for cardiovascular complications, reduction of the levels of the individual components of this syndrome (including dyslipidaemia) has been proven to decrease considerably the rate of cardiovascular events, both primary as well as secondary.
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