Cholesterol is a waxy substance that is made by the body and found in some animal-based foods. Blood cholesterol levels describe a group of fats also known as lipoproteins which includes HDL-C, or "good" cholesterol and LDL-C or "bad" cholesterol. Cholesterol is important to overall health, but when levels are too high, cholesterol can be harmful by contributing to narrowed or blocked arteries. Unfortunately, people with diabetes are more prone to having unhealthy high cholesterol levels, which contributes to cardiovascular disease (CVD). 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 measures:
- Low-density-lipoprotein (LDL) cholesterol = "bad" cholesterol
A high LDL-C level is associated with a higher risk for CVD. 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, it’s important to work with your doctor to manage your LDL appropriately. A diet high in saturated and trans fats can raise your LDL cholesterol.
- High-density-lipoprotein (HDL) cholesterol = "good" cholesterol
With HDL-C, higher levels are associated with a lower risk for CVD. 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 contribute to 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, peripheral artery disease (PAD) 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.
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 January 2016.