The rising prevalence of type 1 (T1D) and type 2 (T2D) diabetes in children and adolescents has resulted in a prolonged disease burden, increasing the risk of complications at a younger age. Additionally, youth with diabetes experience disproportionately high levels of dyslipidemia, which in combination with hyperglycemia, hypertension, and endothelial dysfunction increases their risk of early-onset cardiovascular disease (CVD) compared to their peers without diabetes. These risks are further intensified by existing health disparities. Early screening, prevention efforts, and effective management of cardiovascular risk factors, including dyslipidemia, are crucial for improving patient outcomes and quality of life. This chapter will explore an overview of lipid metabolism, the effects of abnormal lipid profiles on cardiovascular disease in young individuals living with diabetes, existing screening guidelines, and therapeutic management strategies.