Type 2 diabetes mellitus is associated with a markedly increased risk of cardiovascular disease. A complex dyslipidemia, which is an integral part of the underlying insulin resistance in this group, is a key to this increased risk. Increased secretion of VLDL from the liver is a central feature of dyslipidemia and is linked significantly to the low HDL and abnormal LDL that are also present. A number of physiologic and pharmacologic approaches are available and should be used aggressively to treat diabetic dyslipidemia.