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Diabetes and Cholesterol

Getting down to the details

If you have diabetes, you're more likely to have more cholesterol abnormalities — which contributes to cardiovascular disease. Managing your cholesterol, and especially lowering LDL cholesterol, reduces your chance of cardiovascular disease and death. In fact, a person with diabetes who lowers his LDL cholesterol can reduce the risk of having a heart attack by up to 42 percent.

How do I know my cholesterol numbers?

A lipid profile is a measure of different kinds of fats in your blood. Your healthcare provider determines your lipid profile based on your total cholesterol, LDL ("bad") cholesterol, HDL ("good") cholesterol and triglyceride (blood fats) levels.

Diabetics should be tested once or twice a year. For the test the person must fast for 9-14 hours depending what country you live in.

What is cholesterol?

Cholesterol is a waxy substance in your blood that your liver makes. It's also found in foods from animals, such as egg yolks, meat, fish, poultry and whole-milk dairy products. Your body uses cholesterol to make hormones and build cell membranes and other needed tissues. But if too much LDL cholesterol circulates in the bloodstream, it can build up in the inner walls of the arteries and lead to fatty deposits of plaque called atherosclerosis. Learn more.

Cholesterol goals for people with diabetes

People with diabetes have the same risk for heart disease and stroke as people who already have cardiovascular disease. So their target levels for LDL cholesterol are lower.

-Low-density-lipoprotein (LDL) cholesterol is called "bad" cholesterol. When too much LDL cholesterol is in your blood, it may be deposited in the inner walls of your arteries. Together with other substances, it can form plaque and cause your risk of heart disease to increase. So keep your LDL cholesterol level below 100 mg/dL. In some cases, if you have other cardiovascular risk factors, your healthcare provider may want your level to be below 70 mg/dL.

-High-density-lipoprotein (HDL) cholesterol is called "good" cholesterol. HDL cholesterol has the opposite effect of LDL cholesterol. HDL removes cholesterol from the blood. Your HDL cholesterol levels should not be below 40 mg/dL (the higher the better). An HDL cholesterol of 60 mg/dL and above is considered protective against heart disease.

-Triglycerides are the main form in which fats exist in the body. Triglycerides come from fats eaten in foods or are made in the body by the liver. A high triglyceride level contributes to atherosclerosis. Ideally, you want to maintain triglycerides below 150 mg/dL.

How diabetes affects cholesterol

Diabetes tends to lower "good" cholesterol and raise triglyceride and "bad" cholesterol levels, which increases the risk for heart disease and stroke. This common condition is called diabetic dyslipidemia.

"Diabetic dyslipidemia means your lipid profile is going in the wrong direction. It's a deadly combination that puts patients at risk for premature coronary heart disease and atherosclerosis — where the arteries become clogged with accumulated fat and other substances," said Richard Nesto, M.D., a spokesperson for the American Heart Association.

Studies also show a link between diabetic dyslipidemia and insulin resistance, a precursor to type 2 diabetes. If you have insulin resistance (nine out of 10 people with diabetes do), your body doesn't respond efficiently to the insulin it produces.

Avoiding Cholesterol's Bad Side

Now that you know about cholesterol, you can take steps to control it:

Have your cholesterol checked regularly.

-Talk to your doctor about the best plan for you.
-Eat a diet low in saturated fat, trans fat and cholesterol.
-Exercise regularly. Physical activity helps increase your HDL "good" cholesterol.
-Some people may also need to take cholesterol-lowering medications. Ask your doctor about the effects your diabetes medication may have on your cholesterol, since some may improve your lipid profile. Learn more about cholesterol medications.

(mg/dL is the US measurement. Canadian measurement-and I think International is-mmol/L)
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