<International Circulation>: Why is atherogenic dyslipidemia specifically such a significant risk factor for people with diabetes?

　　Prof. Wong: We certainly know that the major type of dyslipidemia in people with diabetes is frequently elevated triglyceride levels in addition to low HDL-C. These problems are frequently not dealt with by statin therapy， being the preponderance of lipid therapy given to such patients.

　　<International Circulation>: How important is it to address these therapies. Obviously the first thing to be done is to lower LDL， but how important is it then to start looking at elevated triglycerides and low HDL-C?

　　Prof. Wong: We know from the CARD Study in people with diabetes involving atorvastatin that statin therapy was able to lower risk of cardiovascular events by 37%. However， that still leaves a large number of events that are still occurring in people who have diabetes. We know from large population survey data such as the National Health and Nutrition Examination Survey that while about two-thirds of people who have diabetes are well controlled in terms of LDL-C， about half still remain not at recommended levels for HDL or triglycerides and also half are not at recommended blood pressure levels. In fact， fewer than 20% of people with diabetes are at recommended levels for A1C， LDL-C and blood pressure. If you add in the restrictions of who is at the recommended levels of HDL-C and triglycerides， then far fewer than 10% are at recommended levels of all of these factors. We still really have a long way to go in trying to comprehensively manage all of the important risk factors in individuals who have diabetes.