Nonpharmacologic Management of Mixed Dyslipidemia Associated with Diabetes Mellitus and the Metabolic Syndrome: A Review of the Evidence

Patients with type 2 diabetes mellitus or metabolic syndrome typically exhibit atherogenic mixed dyslipidemia characterized by low levels of high-density lipoprotein cholesterol, elevated triglycerides, and an increase in small, dense low-density lipoprotein particles. Treatment guidelines recognize lifestyle intervention as a first step in the management of dyslipidemia in these patients. The aim of this article is to review evidence to support this approach. To achieve all recommended lipid goals in clinical practice, lifestyle intervention is likely to be adjunctive to pharmacotherapy.