Atherosclerosis of the coronary, cerebral and peripheral arteries is 2ą4 times more frequent in diabetics than in non-diabetics; it also occurs earlier and progresses more rapidly [1]. In addition, diabetes is associated with disease of the microvasculature, particularly that of the eye and the kidney; this may lead to renal failure, which itself increases the risk of atherosclerosis of large vessels. Overall cardiovascular disease of atherosclerotic origin is a main cause of morbidity and the commonest cause of death in diabetics [2]; in the UK Prospective Diabetes Study, for example, macrovascular disease accounted for fully 59% of deaths in patients with type 2 diabetes [3]. In most studies, the excess risk of coronary heart disease (CHD) caused by diabetes was relatively greater in women than in men, and was such as to erase the normal difference in CHD incidence between men and premenopausal women [4]. Diabetic women also have an increased risk of peripheral vascular disease. The prognosis of CHD is markedly worse in diabetics than in non-diabetic persons with greater mortality following a Ūrst myocardial infarction (MI) and greater recurrence rate [5ą7]. Moreover, possibly because of concomitant diabetic autonomic neuropathy [8], MI in diabetics may be painless and therefore overlooked [7, 9ą13]. Contrary to what is sometimes thought, hyperlipidaemia in patients with type 1 diabetes mellitus is not more common than in the general population. In type 2 diabetes mellitus, by contrast, dyslipidaemia is an almost universal feature and may predate the development of frank diabetes by many years. Therefore, and because of the general aetiological differences, the associations of type 1 and type 2 diabetes mellitus with dyslipidaemia and cardiovascular disease are discussed separately in this review.