In type 2 diabetes mellitus, elevated fasting and postprandial plasma triglycerides, small dense low-density lipoprotein particles, low high-density lipoprotein (HDL) cholesterol levels, and increased action of lipid transfer proteins may enhance peripheral lipid accumulation and increase cardiovascular risk. Despite low HDL cholesterol, plasma's ability to stimulate cellular cholesterol efflux, reflecting an early step in the reverse cholesterol transport pathway, appears to be maintained, perhaps implicating a compensatory mechanism.