Schwartz GG, Szarek M, Bittner VA, et al. - Researchers investigated the relationship between lipoprotein(a) concentration and incident type 2 diabetes, as well as the effects of treatment with alirocumab, a PCSK9 inhibitor. Incident diabetes has been determined from the laboratory, medication, and adverse event data. Over a median of 2.7 years, 1,324 of 13,480 patients who did not have diabetes at baseline developed type 2 diabetes. Data reported that median baseline lipoprotein(a) was 21.9 mg/dL. Baseline lipoprotein(a) concentration was found to be inversely related to incident type 2 diabetes in patients with the acute coronary syndrome. Overall, alirocumab had no effect on the occurrence of type 2 diabetes. However, treatment-related reductions in lipoprotein(a), which were more pronounced when compared with high baseline levels, were linked to an increased risk of incident type 2 diabetes. It is unknown whether these findings apply to other therapies that reduce lipoprotein(a).