This study aimed to determine the effectiveness of a dietitian-led, protocol-driven Diabetes Centre lipid clinic in which the dietitian is empowered to give advice on both lifestyle and lipid-lowering medication. A total of 110 consecutive patients with type 1 and type 2 diabetes attending the clinic received diet and lifestyle advice in conjunction with statin monotherapy or combined statin and fibrate therapy titrated with the aim of achieving target lipid levels. At the time, therapeutic targets were: total cholesterol <5.0mmol/L, LDL cholesterol <2.5mmol/L or a reduction in LDL cholesterol of 30% (whichever was lower) and triglycerides <2.3mmol/L. Results following three clinic visits indicated that total cholesterol fell significantly from 6.23 (6.08, 6.39) (mean [95% CI]) to 4.38 (4.30, 4.46) mmol/L (p<0.001) and triglycerides from 3.03 (2.59, 3.47) to 2.08 (1.87, 2.29) mmol/L (p<0.001). HDL rose slightly, but non-significantly, from 1.21 (1.15, 1.27) to 1.23 (1.17, 1.29) mmol/L. These levels were maintained after 12 months of follow up. In all, 74% of patients had achieved lipid levels within the target range after three clinic visits. No patients experienced serious adverse events from the drug therapy. This study demonstrates that dietetic management of dyslipidaemia using a stepwise approach is both safe and effective in diabetic patients without major complications. Copyright © 2006 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]