OBJECTIVES: To describe and quantify patterns of prescription drug use in diabetic dyslipidemia patients after elevated triglycerides METHODS: A descriptive analysis was performed on a pharmacy and lab data from managed care and Medicare patients in a large Northern California integrated health system 2003-2006. Patients were selected if: 1) a diagnosis of diabetes; 2) a cholesterol profile lab test available; and 3) pharmacy data available for 6 months prior and 12 months post the latest lab test. The selected patients were classified into four triglyceride levels (N=normal, BH=borderline high, H=high and VH=very high) according to the National Cholesterol Education Program Adult Treatment Panel (NCEP-ATP) III recommendation. Patterns and changes in drug therapy of four triglyceride groups were compared by frequencies and the average sum of days of supply (ASDS) around the lab test (prior 6-month data vs. a half of post 12-month data). RESULTS: Of 11,181 patients with diabetes, 259 had both cholesterol lab data and pharmacy data, for which, the mean age was 62.4 (range 32-75), 40.5% females, and 94.6% with hypertension. From their triglyceride level, 108 subjects were classified as normal (41.7%), 48 borderline high (18.5%), 93 high (35.9%), and 10 very high (3.9%). Across the groups, both frequencies and ASDS of drugs increased significantly after the lab test. ASDS of both antidiabetics and antihyperlipidemics increased 195-447% (antidiabetics N=272%, BH=446%, H=447%, VH=195%; antihyperlipidemics N=228%, BH=235%, H=432%, VH=197%), while ASDS of antihypertensives increased 131-628% (N=238%, BH=377%, H=628%, VH=131%). Among antihypertensives, diuretics use increased most (N=241%, BH=747%, H=1086%, VH=100%), possibly a switch to combination therapy. Frequencies showed a similar pattern across the groups but with more variation (antidiabetics=200-725%, antihyperlipidemics=167-800%, antihypertensives=129-878%). CONCLUSIONS: Elevated triglycerides in diabetic patients is associated with higher compliance (antidiabetics, antihyperlipidemics, and antihypertensives) and initiation of more aggressive drug therapy, most noticeably in borderline high and high groups.