Coronary heart disease (CHD) is increasingly recognized as the major complication in people with type 2 diabetes. Recent data from large endpoint trials have provided convincing evidence that lowering of LDL cholesterol reduces cardiovascular disease events in people with type 2 diabetes. Consequently, the main target for therapy has been defined to be LDL cholesterol (goal <2.6 mmol/l). Hydroxymethylglutaryl coenzyme A reductase inhibitors (statins) are recommended for first-line therapy. Optimum therapy of diabetic dyslipidemia should specifically attack those lipid abnormalities that are most common for diabetic dyslipidemia: elevated triglycerides and low HDL cholesterol. In this regard, fibrates provide an option that produces greater changes of these abnormalities than do statins. Effective therapy will be crucial to reduce the excess risk of CHD beyond LDL cholesterol in people with type 2 diabetes. Ongoing trials performed specifically in people with diabetes will likely provide the data regarding how to optimize and individualize the management of diabetic dyslipidemia.