Health Tips & Articles

Diabetes and Cholesterol

by Anne B. Shain, MD

If you have diabetes, your doctor has likely ordered cholesterol testing sometime within the last year. Usually, a lipid panel is ordered. Lipid studies measure the fat in your bloodstream. Cholesterol is one type of lipid. Diabetics already have a higher risk of cardiac disease, stroke and circulation problems. Elevated cholesterol levels have been shown to increase your risks for these problems even further.

Be aware that lowering your cholesterol will greatly reduce these risks. Not all lipids are created equal though, and you will want to know the breakdown of the different lipid levels measured. Lipid levels are usually measured after a 9-12 hour fast and are broken down into four basic types: total cholesterol, LDL, HDL and TG.

The total cholesterol is simply the total number. Usually the guideline is for the total to be less than 200 but it may be okay to be higher if the reason is because the good cholesterol is really high.

LDL (low density lipoprotein) is considered the bad cholesterol. You want the LDL to be as low as possible. Diabetics should have the LDL less than 100. This cholesterol is responsible for cholesterol being deposited into your arteries and causing arterial blockage.

HDL (high density lipoprotein) is considered the good cholesterol. The higher the better but anything greater than 40 is acceptable. The HDL cholesterol transports LDL cholesterol away from the arteries.

TG (triglycerides) are another measure of fat in the blood stream. Very elevated triglycerides may be associated with arterial blockage particularly if the HDL level is low. Treatment of elevated triglycerides may be recommended for this reason. In addition, markedly elevated triglyceride by itself can cause pancreatitis.

Generally accepted cholesterol goals for diabetics are:

Total cholesterol < 200
LDL < 100
HDL > 40
TG < 150

Do not panic is your numbers are not perfect. High cholesterol can be treated with diet, exercise, weight loss and medication to both lower the LDL and raise the HDL. Unfortunately, it is not easy. Successful cholesterol treatment will mean a lifetime of commitment and permanent lifestyle changes to work. It is a worthwhile goal, however, when you consider that it may prevent a heart attack or stroke.


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