Alterations in lipoprotein levels and composition may contribute to th
e greater risk of vascular disease in people with diabetes. The untrea
ted diabetic state is characterized by reduced lipoprotein lipase acti
vity with elevated triglyceride and reduced HDL levels. Lipid levels i
n IDDM nearly normalize with conventional diabetes therapy and improve
with intensive diabetes control, despite significant weight gain. The
hypertriglyceridemia and low HDL levels of NIDDM may persist despite
institution of diabetes therapy, and the effect of long-term intensive
diabetes therapy on lipid levels is not yet known.