The choice of a particular agent depends on the baseline lipid profile achieved after 6 to 12 weeks of intense lifestyle changes and possible use of dietary supplements such as stanols. A simplified algorithm of drug therapy for dyslipidemia in diabetic subjects is shown in Figure 2. The values of the serum lipid profile are not intended to represent goals of therapy, but rather are suggested as trigger points for initiation or modification of drug choices. If the predominant lipid abnormality is hypertriglyceridemia with serum triglyceride concentration greater than 500 mg/dL (5.6 mmol/L), then fibrates would be considered the first choice of therapy. In subsequent follow-up, when LDL-C level is greater than 130 mg/dL (3.4 mmol/L), then a statin is added as a combination therapy. Other options to be used in combination with the fibrate could include niacin, bile acid–binding resin, or, when available, a cholesterol absorption inhibitor.72 On the other hand, if the serum triglyceride levels are less than 500 mg/dL (5.6 mmol/L) and the LDL-C values are greater than 130 mg/dL (3.4 mmol/L), then a statin would be the first drug of choice. The statin dose can be titrated up to achieve the therapeutic goal or, alternatively, a bile acid–binding resin is added if the serum triglyceride concentrations do not exceed 200 mg/dL (2.3 mmol/L). Otherwise, a fibrate, niacin, or, when available, a cholesterol absorption inhibitor would be considered. The use of a drug combination as first-line therapy is also an alternative; however, the clinical experience with this approach is limited. The combination of a statin with a fibrate or niacin increases the risk of rhabdomyolysis, and therefore a low dose of statins (10-20 mg) or a statin with the least drug interaction potential, such as pravastatin sodium, should be used.