Type 1 diabetics harbor a greatly elevated risk for progressive atherosclerosis and cardiovascular events, but the mechanistic basis for this phenomenon is not entirely clear. Although this link is likely to involve many factors, the specific activation of a lipid-driven inflammatory phenotype in monocytes and macrophages of people with type 1 diabetes is an attractive causal mechanism, due to the ability of inflamed macrophages to exacerbate plaque deposition, expansion, and instability.