Multiple mechanisms associated with insulin resistance may promote diabetic atherosclerosis in type 2 diabetes: 1. Secretion of adipokines from adipose tissue (adiponectin, apelin, or leptin), 2. fatty acid binding protein (FABP) aP2 secretion from adipocytes, macrophages (Mϕ) or foam cells, 3. C peptide as a decomposition product of proinsulin, and 4. diabetic hyperlipidemia. Lipoprotein lipase (LPL) is inversely associated with insulin resistance, non-enzymatically glycated hemoglobin (HbA1c), and atherosclerosis. IRS-1 = insulin receptor substrate-1, SR-A = scavenger receptor class A