We were surprised to find that with the spread of knowledge about diabetes, many people are aware of the dangers of high blood sugar and the concept of lowering blood sugar has become more popular. It is true that for diabetic patients, lowering blood glucose is undoubtedly the cornerstone of treatment, because high blood glucose is the “initiator” of all complications of diabetes, and the role of lowering blood glucose in controlling complications is self-evident. However, at the same time when hyperglycemia starts, vascular complications have been quietly staged, but for a long time, patients do not notice, once there are obvious symptoms, vascular lesions have been quite serious, and even cardiovascular and cerebrovascular accidents, this is what we often call “atherosclerosis”, can be called This is often referred to as “atherosclerosis”, known as the “silent killer”. Prevention of atherosclerosis involves lowering blood lipids, therefore, for diabetic patients, they should lower both sugar and lipids, one to treat the root cause and one to treat the symptoms, in order to achieve the purpose of delaying the disease and prolonging life. The following shallow description of the relationship between hyperglycemia, atherosclerosis, and lipid lowering. I. Diabetes and atherosclerosis Diabetes often leads to atherosclerosis of the heart, lower limbs and brain, and eventually myocardial infarction, amputation and cerebral infarction. The reason is that hyperglycemia can lead to hyperlipidemia, and hyperglycemia and dyslipidemia can cause vascular endothelial cell function and smooth muscle cell function disorder, which contributes to vascular endothelial inflammation reaction, foam cell increase, smooth muscle cell migration, and the formation of lipid streaks in the inner wall of arterial blood vessels, this lipid streak is early atherosclerosis, at this time, vascular endothelial cell function is already abnormal, and endothelial cells play an important role for blood flow. The endothelium plays an important role in blood flow. The abnormal function of smooth muscle further aggravates atherosclerosis, resulting in the accumulation of more and more lipid substances, which eventually leads to a significant shortage of blood supply and thrombosis. In response to the abnormalities of blood lipids in diabetic patients, lipid-lowering drugs such as statins or fibrates are available. Several studies have demonstrated that statins significantly reduce the risk of macrovascular disease and death by lowering cholesterol and low-density lipoprotein. In contrast, fibrates exert anti-atherosclerotic effects by lowering triglycerides, increasing HDL, and anti-inflammatory effects. Statins should be added for the following patients regardless of lipid levels: 1) those with definite cardiovascular disease; 2) those over 40 years of age, smokers, and hypertensives, although they do not have cardiovascular disease. Statins should be used in all diabetic patients with LDL above 2.6 mmol/L. The role of statins in anti-atherosclerosis and reducing macrovascular events has been well demonstrated in the recent CARDS trial. For high triglycerides one should use beta lipid-lowering agents. In summary, for diabetic patients, while lowering sugar is important, lowering lipids is also indispensable, and a two-pronged approach can be considered a wise way to reduce macrovascular events.