The treatment of lipid disorders begins with lifestyle therapy to improve nutrition, physical activity, weight, and other factors that affect lipids. Secondary causes of lipid disorders should be addressed, and pharmacologic therapy initiated based on a patient's risk for atherosclerotic cardiovascular disease (ASCVD). Patients at extreme ASCVD risk should be treated with high-intensity statin therapy to achieve a goal low-density lipoprotein cholesterol (LDL-C) of <55 mg/dL, and those at very high ASCVD risk should be treated to achieve LDL-C <70 mg/dL. Treatment for moderate and high ASCVD risk patients may begin with a moderate-intensity statin to achieve an LDL-C <100 mg/dL, while the LDL-C goal is <130 mg/dL for those at low risk. In all cases, treatment should be intensified, including the addition of other LDL-C-lowering agents (i.e., proprotein convertase subtilisin/kexin type 9 inhibitors, ezetimibe, colesevelam, or bempedoic acid) as needed to achieve treatment goals. When targeting triglyceride levels, the desirable goal is <150 mg/dL. Statin therapy should be combined with a fibrate, prescription-grade omega-3 fatty acid, and/or niacin to reduce triglycerides in all patients with triglycerides ≥500 mg/dL, and icosapent ethyl should be added to a statin in any patient with established ASCVD or diabetes with ≥2 ASCVD risk factors and triglycerides between 135 and 499 mg/dL to prevent ASCVD events. Management of additional risk factors such as elevated lipoprotein(a) and statin intolerance is also described.

Associate Editor the Journal of Diabetes Medical Director Scripps Whittier Diabetes Institute Clinical Professor of Medicine UCSD President Diabetes and Endocrine Associates San Diego California

Chairman Grunberger Diabetes Institute Clinical Professor Internal Medicine and Molecular Medicine and Genetics Wayne State University School of Medicine Professor Internal Medicine Oakland University William Beaumont School of Medicine Visiting Professor Internal Medicine 1st Faculty of Medicine Charles University Prague Czech Republic Past President American Association of Clinical Endocrinologists Bloomfield Hills Michigan

Clinical Assistant Professor of Medicine Voluntary Faculty University of California San Diego San Diego California

Clinical Professor Medicine University California Irvine School of Medicine Irvine California Co Director Diabetes Out Patient Clinic UCI Medical Center Orange California Director and Site Principal Investigator Diabetes Lipid Management and Research Center Huntington Beach California

Director Adult Type 1 Diabetes Program Division of Endocrinology Diabetes and Metabolism The Ohio State University Wexner Medical Center Columbus Ohio

Editor the Journal of Diabetes Clinical Professor Icahn School of Medicine at Mount Sinai New York New York

Endocrinologist Clinical Lipidologist Associate Professor of Medicine Icahn School of Medicine Mount Sinai Director Lipids and Metabolism Mount Sinai Heart New York New York

Medical Director and Principal Investigator Metabolic Institute of America Tarzana California

President Utah Lipid Center Salt Lake City Utah Past President American Board of Clinical Lipidology Torrance California

Professor Departments of Medicine Biochemistry and Cell and Molecular Biology Baylor College of Medicine Houston Texas

Professor Director of the Lipid Clinic University of Chicago Pritzker School of Medicine Chicago Illinois

Professor of Clinical Medicine Voluntary Faculty University of Miami Miller School of Medicine Center for Diabetes and Endocrine Care Hollywood Florida

Professor of Medicine and Pharmacology Assistant Dean for Clinical Research Tullis Tulane Alumni Chair in Diabetes Chief Section of Endocrinology Tulane University Health Sciences Center New Orleans Louisiana

Professor of Medicine Medical Director The Marie Josee and Henry R Kravis Center for Clinical Cardiovascular Health at Mount Sinai Heart Director Metabolic Support Divisions of Cardiology and Endocrinology Diabetes and Bone Disease Icahn School of Medicine at Mount Sinai Heart Director Metabolic Support Divisions of Cardiology and Endocrinology Diabetes and Bone Disease Icahn School of Medicine at Mount Sinai New York New York

Professor of Medicine UCLA Endowed Chair of Preventive Cardiology Los Angeles Biomedical Research Institute Torrance California

Professor of Pediatrics and Medicine UCSF Adjunct Professor Department of Nutritional Sciences University of California Berkeley Dolores Jordan Endowed Chair UCSF Benioff Children's Hospital Oakland New York New York

The William and Sonja Connor Chair of Preventive Cardiology Professor of Medicine and Physiology and Pharmacology Director Center for Preventive Cardiology Knight Cardiovascular Institute Oregon Health and Science University Portland Oregon

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