Medical nutrition therapy is paramount preventing diabetes. Fish and dietary fiber are beneficial for diabetes patients; however few studies investigated the effects of both of them on the lipid profiles among diabetes patients. We found that participants in high fish consumption with adequate fiber intake corresponded to a significantly lower serum triglyceride. Furthermore, plasma fatty acid fractions were significantly corresponded to the dietary fish consumptions. Considering these observations, it might be appropriate to recommend a higher fish intake with the adequate dietary fiber for patients who are at high risk of diabetes-related dyslipidemia.