Cholesterol, which is a soft, waxy substance found in the bloodstream and the body's cells, is important to overall health. However, not all cholesterol is created equal. There is "good" cholesterol, of which the body needs an ample supply, and "bad" cholesterol, which should be kept to a minimum. Unfortunately, people with diabetes are more prone to having unhealthy cholesterol levels, which contributes to cardiovascular disease. By taking steps to manage cholesterol, individuals can reduce their chance of cardiovascular disease and premature death.
Using a blood sample taken after a brief period of fasting by the patient, a lipoprotein profile reveals the following lipid levels:
- Low-density-lipoprotein (LDL) cholesterol = "bad" cholesterol
A low LDL cholesterol level is considered good for your heart health. However, your LDL number should no longer be the main factor in guiding treatment to prevent heart attack and stroke, according to the latest guidelines from the American Heart Association. For patients taking statins, the guidelines say they no longer need to get LDL cholesterol levels down to a specific target number. A diet high in saturated and trans fats raises LDL cholesterol.
- High-density-lipoprotein (HDL) cholesterol = "good" cholesterol
With HDL (good) cholesterol, higher levels are better. Low HDL cholesterol puts you at higher risk for heart disease. People with high blood triglycerides usually also have lower HDL cholesterol. Genetic factors, type 2 diabetes, and certain drugs, such as beta-blockers and anabolic steroids, also lower HDL cholesterol levels. Smoking, being overweight and being sedentary can all result in lower HDL cholesterol.
Triglyceride is the most common type of fat in the body. Normal triglyceride levels vary by age and sex. A high triglyceride level combined with low HDL cholesterol or high LDL cholesterol is associated with atherosclerosis, the buildup of fatty deposits in artery walls that increases the risk for heart attack and stroke.
How does diabetes affect cholesterol?
Diabetes tends to lower "good" cholesterol levels 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," said Richard Nesto, M.D., a spokesperson for the American Heart Association. "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."
Studies show a link between insulin resistance, which is a precursor to type 2 diabetes, and diabetic dyslipidemia, atherosclerosis and blood vessel disease. These conditions can develop even before diabetes is diagnosed.
Learning how to prevent and treat abnormal cholesterol levels is an important step in maintaining optimum health.
This content was last reviewed August 2015.