Internal Medicine

Is there a connection between diabetes and high cholesterol?

Elizabeth L Helfer MD FACP

There is a connection between diabetes and high cholesterol and that connection centers on your heart. Both conditions attack your cardiovascular system. In fact, statistics indicate that heart disease and stroke are responsible for as many as 65 percent of the deaths in people with diabetes. If you have been diagnosed with diabetes or pre-diabetes, your physician should also be closely monitoring your cholesterol by prescribing a lipid panel at least once each year.

A lipid panel is a blood test that measures the amount of cholesterol in your blood. It will determine the amount of LDL (“bad“) cholesterol, HDL (“good“) cholesterol and triglycerides in your blood. If you have trouble with the difference between the two types of cholesterol, just look at the first letter. You want your LDL number to be low and you want your HDL level to be high.

Your body needs cholesterol to function properly. It helps to keep flexible the membranes around cells, and it is important in the formation of hormones like estrogen and testosterone. When you have too much LDL in your blood; however, the excess tends to stick to the walls of blood vessels in the form of a substance called plaque. As more of this forms, the opening in the blood vessel narrows, restricting the flow of blood. At the same time, HDL works to clear excess cholesterol from the blood.

Compounding this is the fact that diabetes tends to increase LDL cholesterol and decrease the amount of HDL cholesterol, which is exactly the opposite of what you need for good cardiovascular health. In essence, if you have both high cholesterol and high blood sugar levels, you are multiplying your risk of premature death from cardiovascular disease.

If you’ve been diagnosed with high cholesterol, diabetes or pre-diabetes, you need to consider making immediate lifestyle changes. The complications of these conditions – stroke, heart attack, kidney disease – may seem remote at the time of your diagnosis, but the fact that you have been diagnosed means that changes are already occurring in your body that could lead to these complications. Your physician can guide you in making these lifestyle changes. Not surprisingly, they are ones you have probably heard before:

• If you smoke, you need to quit. Smoking lowers your HDL.
• If you are overweight – even slightly – you need to change your diet and exercise more. Losing just five to ten percent of your body weight – as little as 10 to 20 pounds for a 200-pound individual – could significantly lower your blood sugar level. According to the American Diabetes Association, studies have shown that people with prediabetes who lose weight and who engage in some modest form of exercise (30-60 minutes per day, 5-7 days per week) can prevent or delay the development of type 2 diabetes by up to 58 percent.

If lifestyle changes aren’t successful in bringing your cholesterol and blood sugar levels under control, then your physician can prescribe safe and effective medications for you.

Originally published in The University Doctors' MedicaLink - 11/09