How To Reduce Cholesterol In People With Diabetes
For people with diabetes and related dyslipidemia, diet and exercise may not be enough to lower LDL-C to less than 100 mg/dl. People with diabetes may need a statin or other medication in order to get their cholesterol to goal. Care should be taken to get people with diabetes to their cholesterol goals, as it can significantly impact their health over the long term if blood glucose and blood pressure are also controlled.
Living With Metabolic Syndrome
Metabolic syndrome is a lifelong condition that will require changes in your lifestyle. If you already have heart disease or diabetes, follow your healthcare providers recommendations for managing these conditions.
Lifestyle changes involved in managing metabolic syndrome include:
- A healthy diet
- Stopping smoking if youre a smoker or use other tobacco products
- Losing weight if you are overweight or obese
What Is Metabolic Syndrome
Metabolic syndrome refers to the presence of a cluster of risk factors specific for cardiovascular disease. Metabolic syndrome greatly raises the risk of developing diabetes, heart disease, stroke, or all three.
According to the National Heart, Lung and Blood Institute , the cluster of metabolic factors involved includes:
- Abdominal obesity. This means having a waist circumference of more than 35 inches for women and more than 40 inches for men. An increased waist circumference is the form of obesity most strongly tied to metabolic syndrome.
- High blood pressure of 130/80 mm Hg or higher. Normal blood pressure is defined as less than 120 mm Hg for systolic pressure , and less than 80 mm Hg for diastolic pressure . High blood pressure is strongly tied to obesity. It is often found in people with insulin resistance.
- Impaired fasting blood glucose. This means a level equal to or greater than 100 mg/dL
- High triglyceride levels of more than 150 mg/dL. Triglycerides are a type of fat in the blood.
- Low HDL cholesterol. Less than 40 mg/dL for men and less than 50 mg/dL for women is considered low.
The NHLBI and AHA recommend a diagnosis of metabolic syndrome when a person has 3 or more of these factors.
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What Is Cholesterol And Is It Unhealthy
Cholesterol is a waxy substance found in your body and in animal products such as meat, eggs, and dairy.
It plays important roles in the production of hormones, vitamin D, and the bile necessary for digesting fats. Its also an essential component of every cell in your body, giving cell membranes strength and flexibility .
Your liver produces all the cholesterol your body needs to function, but cholesterol can also be introduced by eating animal products.
Since cholesterol doesnt mix well with liquids such as blood, its transported by particles called lipoproteins, including low density and high density lipoprotein or LDL and HDL.
LDL is often referred to as bad cholesterol because its associated with plaque buildup in your arteries, while HDL helps excrete excess cholesterol from your body .
When you consume extra cholesterol, your body compensates by reducing the amount that it naturally makes. In contrast, when dietary cholesterol intake is low, your body increases cholesterol production to ensure that theres always enough of this vital substance .
Only about 25% of cholesterol in your system comes from dietary sources. Your liver produces the rest .
Hdl Cholesterol Or Good Cholesterol
HDL cholesterol is sometimes called good cholesterol. It helps return LDL cholesterol to your liver to be removed from your body. This helps prevent cholesterol plaque from building up in your arteries.
When you have healthy levels of HDL cholesterol, it can help lower your risk of blood clots, heart disease, and stroke.
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Diabetes And Your Heart
You can lower your risk for heart disease with lifestyle changes.
Diabetes and heart disease often go hand in hand. Learn how to protect your heart with simple lifestyle changes that can also help you manage diabetes.
Heart disease is very common and serious. Its the leading cause of death for both men and women in the United States. If you have diabetes, youre twice as likely to have heart disease or a stroke than someone who doesnt have diabetesand at a younger age. The longer you have diabetes, the more likely you are to have heart disease.
But the good news is that you can lower your risk for heart disease and improve your heart health by changing certain lifestyle habits. Those changes will help you manage diabetes better too.
How Can I Lower My Cholesterol Level
The first step in reducing your cholesterol is to maintain a healthy, balanced diet. It’s important to keep your diet low in fatty food.
You can swap food containing saturated fat for fruit, vegetables and wholegrain cereals. This will also help prevent high cholesterol returning.
If these measures don’t reduce your cholesterol and you continue to have a high risk of developing heart disease, your GP may prescribe a cholesterol-lowering medication, such as statins.
Your GP will take into account the risk of any side effects from statins. The benefit of lowering your cholesterol must outweigh any risks.
Read more about how high cholesterol is treated
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What Is High Cholesterol
High cholesterol is a condition in which you have too many lipids in your blood. Its also called hyperlipidemia or hypercholesterolemia.
Your body needs just the right amount of lipids to function. If you have too many lipids, your body cant use them all. The extra lipids start to build up in your arteries. They combine with other substances in your blood to form plaque .
This plaque might not cause any problems for years, but over time, the plaque silently gets bigger and bigger within your arteries. This is why untreated high cholesterol is dangerous. Those extra lipids in your blood help make the plaque bigger without you even knowing it. The only way to know you have high cholesterol is through a blood test.
Good cholesterol vs. bad cholesterol
There are several types of lipids. The main ones youve probably heard about are good cholesterol and bad cholesterol.
Good cholesterol is called high-density lipoprotein . Think of the H as meaning helpful. Your HDLs carry cholesterol to your liver. Your liver keeps your cholesterol levels balanced. It makes enough cholesterol to support your bodys needs and gets rid of the rest. You must have enough HDLs to carry cholesterol to your liver. If your HDLs are too low, youll have too much cholesterol circulating in your blood.
After A Meal Take A Walk
As someone with diabetes, you already know that exercise is key for keeping your blood sugar levels under control.
Exercise is also key for managing high cholesterol. It can help increase levels of HDL cholesterol, which are protective against heart disease. In some cases, it can also reduce levels of LDL cholesterol.
Probably the most effective exercise you can do to help control blood sugar levels is to take a walk after eating a meal.
A small New Zealand study published in Diabetologia reported that the improvement in blood sugar levels was particularly striking when participants walked after the evening meal. These participants experienced greater blood sugar reduction than those who just walked whenever they liked.
Walking is good for high cholesterol, too. In a 2013 study published in
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Effects Of Hypoglycemic Agents On Lipoproteins
Diabetes dyslipidemia can be partly corrected by insulin treatment and improved blood glucose control . Insulin therapy increases HDL cholesterol and reduces circulating triglyceride levels, particularly in patients with poor glycemic control . Metformin decreases serum triglycerides and improves insulin resistance but is often overlooked as a lipid-lowering agent and is generally considered only as a hypoglycemic agent in the management of diabetes . Other drugs used in the management of diabetes may also have unintended positive and negative effects on lipoproteins . Of particular interest is the small increase in LDL cholesterol observed following treatment with sodium-glucose cotransporter 2 inhibitors, suggesting that the recently reported significant improvement in cardiovascular outcomes with empagliflozin is unrelated to effects on dyslipidemia .
What About Type 1 Diabetes
For decreasing cardiovascular risk in Type 1 diabetes, blood glucose control seems to make the greatest difference. Having a blood glucose in your target range will get a person with Type 1 diabetes very close to normal as far as cholesterol levels are concerned. People with Type 1 diabetes that is not managed well have increased triglycerides and also they have lower HDL-C, or good cholesterol. These two things contribute to cardiovascular disease in Type 1 diabetics.
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Top Misconceptions About High Cholesterol
This post is available in: Spanish
Did you know that slender people can have high cholesterol? Or that getting older even if youre physically fit can cause LDL, or the bad cholesterol, to rise?
There are plenty of misconceptions about cholesterol, and that can make some adults candidates for life-altering events, such as a heart attack or a stroke.
Cholesterol circulates in the blood and can mix with other substances to form a thick, hard deposit on the inside of the arteries. This can narrow the arteries and make them less flexible a condition known as atherosclerosis.
If a blood clot forms and blocks one of these narrowed arteries, a heart attack or stroke can result. This is why high cholesterol is one of the major risk factors for heart disease.
Nearly one of every three U.S. adults have high levels of low-density lipoprotein cholesterol , which is considered the bad cholesterol because it contributes to fatty plaque buildups and narrowing of the arteries. About 94.6 million, or 40 percent, of U.S. adults have total cholesterol of 200 mg/dL or higher. LDL-C levels of 100 mg/dL or lower are linked to lower rates of heart disease and stroke.
High cholesterol is one of the major controllable, or modifiable, risk factors for coronary heart disease, heart attack and stroke. If you have other risk factors such as smoking, high blood pressure or diabetes, your risk increases even more.
See Your Diabetes Educator
Work with a diabetes care and education specialist for help avoiding health complications such as heart disease. Youll get support and solutions and hear about the latest advances in managing diabetes. Find out more about how diabetes education can help you take the best care of yourself. And be sure to ask your doctor for a referral if you dont already have a diabetes educator.
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Cut Down On Foods That Are High In Cholesterol
Reading food labels helps when trying to cut down on foods high in cholesterol. Look for labels that say low cholesterol, or no cholesterol. Look for foods that are low in fat. You can cut down on egg yolks, and eat more egg whites. Cut down on fried foods in general, and things like gravy, biscuits, and other foods known to be high in fat. Bake, grill, or broil meats, and trim excess fat.
Lift A Few Heavy Things
As we age, we naturally lose muscle tone. Thats not good for our overall health, or for our cardiovascular health. You can resist that change by adding some weight training to your weekly schedule.
Researchers in the Diabetes Care study mentioned previously reported that resistance training, or weight training, was an effective way to control cholesterol.
In a 2013 study published in the , researchers found that people who had a regular weight-lifting program had more efficient HDL than those who didnt.
Weight training is beneficial for those with diabetes too. In a 2013 study published in , researchers found that resistance training helped participants build muscle. It also improved overall metabolic health and reduced metabolic risk factors for those with diabetes.
For overall health, its best to combine resistance training with your aerobic exercise. Researchers reported in
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Body Mass Index Target: Less Than 25
Body mass index measures your weight in relation to your height, and should be less than 25. A BMI of 25 or over means you are overweight, and a 30 or higher means you are obese. Extra weight can lead to high cholesterol, heart disease, diabetes, and other chronic illnesses.
Check with your doctor to determine your BMI, then take action to control your weight.
Is Dietary Cholesterol Harmful
Research shows that dietary cholesterol doesnt significantly affect cholesterol levels in your body, and data from population studies doesnt support an association between dietary cholesterol and heart disease in the general population .
Though dietary cholesterol may slightly affect cholesterol levels, this isnt an issue for most people.
In fact, two-thirds of the worlds population experience little or no increase in cholesterol levels after eating cholesterol-rich foods even in large amounts .
A small number of people are considered cholesterol non-compensators or hyper-responders and appear to be more vulnerable to high cholesterol foods. However, hyper-responders are thought to recycle extra cholesterol back to their liver for excretion .
Dietary cholesterol has also been shown to beneficially affect the LDL-to-HDL ratio, which is considered the best indicator of heart disease risk .
While research shows that its unnecessary for most people to avoid dietary cholesterol, keep in mind that not all cholesterol-containing foods are healthy.
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Ldl Cholesterol Or Bad Cholesterol
LDL cholesterol is often called bad cholesterol. It carries cholesterol to your arteries. If your levels of LDL cholesterol are too high, it can build up on the walls of your arteries.
This buildup is also known as cholesterol plaque. This plaque can narrow your arteries, limit your blood flow, and raise your risk of blood clots. If a blood clot blocks an artery in your heart or brain, it can cause a heart attack or stroke.
Treating Cholesterol When You Have Diabetes
If you have high cholesterol and diabetes, itâs important to get treated for both conditions. That will reduce your risk of developing heart disease. Eating a healthy diet and exercising regularly are both crucial for regulating blood sugar. Some research shows that these lead to better cholesterol levels in people with diabetes, too, especially if you lose extra weight.
In addition to making lifestyle changes, your doctor may recommend you take medication to improve your cholesterol levels. Medications that treat high cholesterol levels include:
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Cholesterol And Peripheral Vascular Disease
In addition to your heart and your brain, cholesterol plaque can cause symptoms in your legs and other areas outside of your heart and brain . Legs and feet are most common. You might notice cramps in your calves when you walk that get better with rest. This is like angina — it works the same way — but in your legs instead of your heart.
Cholesterol Is Fat That Is Found In Our Blood Sometimes Its Called Lipids When We Hear This Word We Think Of It Building Up In Our Arteries And Contributing To Long
Healthy levels of cholesterol are vital for our cells to function and to make vitamin D and some hormones.
There are two main types HDL or high-density lipoprotein and LDL or low-density lipoprotein . If the levels of your bad cholesterol become too high and the good cholesterol too low, you are at increased risk of developing cardiovascular complications .
There are also triglycerides . These can have bad effects on your health if levels are high, too.
For many people, eating a healthy, balanced diet and being physically active is enough to keep cholesterol levels healthy. But if your bad cholesterol is high, most people need medication to lower it. And for people with diabetes, it is important that you have your levels checked every year. You can find out why it’s important in our video.
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Diet And Weight Management
Lifestyle modifications are the first-line intervention in the management of diabetes dyslipidemia, and include weight loss, dietary modification, and aerobic exercise . Obesity increases insulin resistance and is associated with increased triglycerides and LDL cholesterol and decreased HDL cholesterol . Weight loss is known to be associated with improvements in lipids and other cardiovascular risk factors including the incidence of type 2 diabetes and should therefore be encouraged in overweight patients with diabetes. To achieve sustained weight loss, caloric restriction remains the key and even modest degrees of weight loss are associated with an improvement in glycemic control, HbA1c, and lipid profile .
Increased physical activity may provide some small adjunct to the effect of dietary restriction, but is unlikely to be successful on its own. Reduced fat intake, particularly of saturated fat, should also be encouraged . The American Diabetes Association recommends a diet low in trans fat, saturated fat, and cholesterol . In patients without a marked increase in serum triglycerides but who are not obese, some substitution of saturated fat can be made with unrefined carbohydrate foods and some with oleic, linoleic, or omega-3 fish oils .
Dietary interventions, while considered first-line treatment for all patients with diabetes, have not been successful in demonstrating a mortality benefit, even with prolonged follow-up .
Diabetes Prevention Programs For Pre
Diabetes Prevention Programs have popped up all around the country. These programs are geared toward achieving weight loss, nutritional, and activity goals in order to prevent Type 2 diabetes later on. The Centers for Disease Control has a model of Diabetes Prevention Programs , and organizations such as the YMCA and others have started to bring these programs to communities. Some insurers have hopped on board with providing these programs, and scholarships are also available in some areas. Check with your individual insurance carrier for benefits that might include these programs, and with local programs providing DPP for scholarship opportunities. On top of decreasing your chances of getting Type 2 diabetes, you will be learning healthy lifestyle changes, including a heart healthy diet, which will also help to get your cholesterol numbers where they need to be.
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