Uptake of modified low density lipoprotein (LDL) by monocyte-macrophages is mediated by the scavenger receptor CD36, which is upregulated in vitro by high glucose concentrations and oxidatively modified LDL. We hypothesised that monocyte CD36 expression would be higher in Type 2 diabetes, and would increase during acute hyperglycaemia. Sixteen subjects with Type 2 diabetes and 11 controls underwent a 75 g oral glucose load. Monocyte CD36 expression (by laser flow cytometry), plasma LDL diene conjugates, plasma LDL hydroxyoctadecadienoic acid-13 (a peroxisome proliferator activator receptor gamma agonist) were measured at 0, 2 and 4 h. Mean monocyte CD36 expression at baseline was 34% higher in the diabetes group (P=0.01), did not change during acute hyperglycaemia and plasma LDL conjugated diene concentration was the only variable directly related to CD36 expression (F=4.53; P=0.05; r=0.51). Higher baseline CD36 expression in Type 2 diabetes could reflect increased post-transcriptional efficiency of CD36 mRNA in response to chronic hyperglycaemia and could be a proatherogenic mechanism in Type 2 diabetes.