The recognition that hypertriglyceridemia is associated with multiple alterations of other lipoproteins that are potentially atherogenic has expanded the picture of diabetic dyslipidemia. Elevation of large VLDL1 particles initiate a sequency of events that results in generation of atherogenic lipoproteins including remnants and small dense LDL. This abnormality is also associated with the lowering of HDL cholesterol. The clinical implication is that the concentration of plasma triglycerides should be maintained as low as possible to avoid these deleterious consequences of hypertriglyceridemia.