In this brief report, Blackburn et al. sought to determine whether the presence of the atherogenic metabolic triad (elevated fasting insulin and apolipoprotein B levels and the presence of small LDL particles) was tied to coronary artery disease in women with (n=191) and without (n=59) type 2 diabetes. Among women with type 2 diabetes, the atherogenic metabolic triad and hypertriglyceridemic waist (combination of increased waist circumference and triglyceride levels) were considerably more common in women with signs of coronary artery disease. Moreover, diabetes alone did not predict coronary artery disease in the absence of the atherogenic metabolic triad. These results are in line with previous studies that have shown that type 2 diabetes without features of the metabolic syndrome causes fewer cardiovascular complications as opposed to the combination of diabetes and metabolic syndrome. This underlines the need to go beyond measurement of fasting glucose in the management of diabetes in women.
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