LPA and diabetes mellitus: M. Kostner et al. calls this phenomenon “The Lp(a) Paradox in Diabetes Mellitus” (52): patients with Type-2 diabetes mellitus (T2DM) may have reduced Lp(a) due to mutations or polymorphisms in genes that affect the expression of the APOA gene, and it could explain the evidence that T2DM patients have lower Lp(a) plasma levels in comparison to individuals without T2DM.