International Circulation: The efficacy of CV risk reduction with statin which is the standard therapy for dyslipidemia in T2DM patients differ from that in the general population?
　　Prof Alberto Zambon: For non diabetic patients who have a risk of cardiovascular disease should be placed on statin therapy as the first therapeutic choice. This mainly if hypercholesterolemia is a major phenotype of those patients. Statins should remain the first choice not only to reduce the risk of cardiovascular events in diabetics but also non diabetics also.
　　International Circulation: So can we optimize reduction of micro vascular risks in T2DM， and what is the role of triglyceride lowering by fibrates?
　　Prof Alberto Zambon: When we talk about residual risks， all the trials with statins have pointed out that there are a subset of patients with a considerable higher risk of these complications than others. One example is represented by diabetic patients who are on a statin，whom still have low levels of HDL and high levels of triglycerides. This is one of the areas where fibrates kicks in because these agents affect HDL and triglycerides and not on LDL. The other point which is somewhat of a surprise is that trials concerning fibrates particularly the two most recent ones presented positive findings on micro vascular complications specifically: diabetic retinopathy and diabetic nephropathy.
　　International Circulation: Which kind of T2DM patients should be considered to receive mono- or combo- therapy of Fenofibrate & Statin in order to reduce residual micro-vascular risks? How about the safety and tolerance of fibrates-based therapy?
　　Prof Alberto Zambon:Firstly we should select patients based on their baseline LDL levels. This means that statin therapy remains the first line therapeutic choice for most if not all patients with diabetes. On statin therapy when we see a patient who has a HDL level below 1.1mmol/L and triglycerides above 1.7mmol/L then we know that patient despite on statin therapy is characterized by increased residual risk， this patient with atherogenic dyslipidemia and diabetes is a candidate for combination therapy.