OBJECTIVE | Reduction of atherosclerotic cardiovascular disease (ASCVD) risk in patients with diabetes requires proper management of lipid parameters. This study aimed to find the pattern of dyslipidemia and scope of ASCVD risk reduction in patients with diabetes by lipid management.METHODS | Clinical, biochemical, and medication profiles of all patients with diabetes attending a tertiary diabetes care hospital over a 2-year period were collected. The prevalence of various lipid abnormalities was determined after excluding patients with thyroid dysfunction and those on lipid-lowering medications. Patients were stratified according to LDL cholesterol, HDL cholesterol, and triglyceride levels, and other clinical parameters were compared among the groups. The adequacy of statin treatment was assessed based on American Diabetes Association guidelines.RESULTS | Nine hundred and seventy-one patients were included. The prevalence of hyperlipidemia was 40.0%, of whom 14.6% were newly diagnosed. The most common lipid abnormality was elevated LDL cholesterol. Higher A1C and fasting blood glucose values were found to be associated with higher LDL cholesterol levels. Twenty-seven percent of patients with indications for treatment with statins were receiving them. Of those being treated with statins, 42.6% had an LDL cholesterol level $100 mg/dL. CONCLUSION | In South Indian patients with type 2 diabetes and fair glycemic control, high LDL cholesterol is the predominant lipid abnormality. There remains a huge potential for ASCVD risk reduction in this population if the knowledge practice gap is addressed.Type 2 diabetes requires proper management of lipid parameters and hypertension in addition to glycemic control to ensure prevention of chronic complications, especially negative macrovascular outcomes. The prevalence of macrovascular complications of diabetes is much higher in Indians than in Caucasians, even though the prevalence of microvascular complications is comparable in these populations (1,2).Only a few studies of lipid parameters in Indian patients with diabetes have been conducted. This knowledge deficit is particularly worrisome with regard to the population of South India, and especially in the state of Kerala, where the predicted risk of atherosclerotic cardiovascular disease (ASCVD) is the highest among the Indian states, with an age-standardized state-level mean 10-year ASCVD risk of 30.4% among males (3). The prevalence of dyslipidemia among people $30 years of age in South India is 74.8% in urban populations (4).International guidelines on the treatment of dyslipidemia in patients with type 2 diabetes advocate aggressive lowering of LDL cholesterol in patients with diabetes based on strong evidence from clinical trials. Therapeutic inertia with regard to glucose, blood pressure, and lipid management in patients with diabetes has been demonstrated in multiple studies around the world (5,6). This study assesses the prevalence and pattern of dyslipidemia, as well as the

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