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High Cholesterol and Diabetes

Medically Reviewed by Brunilda Nazario, MD on June 08, 2021

If you have type 2 diabetes, you might have high cholesterol levels, too. With type 2 diabetes, your body doesn’t regulate or use glucose (sugar) the way it should. That can lead to too-high levels of glucose in your blood.

High glucose levels can contribute to other health conditions, including high cholesterol. But even people with type 2 diabetes who have well-controlled blood sugar may have cholesterol problems. Here’s what you need to know.

What’s the Connection?

Cholesterol is a waxy substance in your blood. Your body makes it. Cholesterol isn’t a bad substance. It helps make the outer layer of our cells and helps make certain vitamins and hormones. It’s also in meat, cheese, and other foods from animals.

But too much cholesterol in your blood can lead to health issues.

There are different types of cholesterol:

  • Low-density-lipoprotein (LDL) cholesterol, or “bad” cholesterol. When your LDL cholesterol levels are too high, your arteries can become too narrow and get blocked. This can cause stroke and heart problems.
  • High-density-lipoprotein (HDL) cholesterol, or “good” cholesterol. Low levels of HDL cholesterol can contribute to heart disease and other issues, especially if your LDL cholesterol and triglyceride levels are high.
  • Triglycerides. These are fats from the food you eat that circulate in your body, which can be stored in fat cells. Triglycerides aren’t actually a type of cholesterol, but their levels are measured along with HDL and LDL in order to determine your odds of developing atherosclerosis (which is when fatty deposits build up in your artery walls). Atherosclerosis puts you at risk for heart attacks, strokes, and peripheral artery disease.

If you have type 2 diabetes and have your blood sugar under control, you still might have high levels of triglycerides and low HDL levels. You may also have higher levels of LDL cholesterol, too. Having poor blood sugar control can make cholesterol levels worse.

If you have diabetes and have low levels of good cholesterol but high levels of bad cholesterol and high triglycerides, you have a condition called diabetic dyslipidemia. Up to 70% of people with type 2 diabetes have diabetic dyslipidemia.

One reason diabetes is linked with heart disease is because people with diabetes tend to have LDL particles that are smaller and denser than those who don’t. This gives it more of a chance to invade blood vessel walls and create plaque in your arteries.

People with type 1 diabetes who have their blood sugar under control usually have normal levels of cholesterol. If they’re overweight or have obesity, though, they’re more likely to have high cholesterol. But that’s true for people without type 1 diabetes, too.

Treating Cholesterol When You Have Diabetes

If you have high cholesterol and diabetes, it’s 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:

  • Statins
  • PCSK9 inhibitors
  • Bile acid resins
  • Fibrates

Your doctor will recommend medication based on your health history. Make sure you take them if your doctor prescribes them. Managing your blood sugar may help with cholesterol and is crucial for improving your overall health.

WebMD Medical Reference

Sources

SOURCES:

Mayo Clinic: “Type 2 diabetes.”

American Heart Association: “Cholesterol and Diabetes.”

Cleveland Clinic: “Triglycerides & Heart Health,” “Cholesterol: High Cholesterol Diseases,” “Cholesterol-Lowering Drugs.” 

World Journal of Diabetes: “Management of diabetic dyslipidemia: An update.”

Diabetes Care: “Dyslipidemia Management in Adults With Diabetes.”

Diabetologia: “Pathology of diabetic dyslipidaemia: where are we?”

Annales Universitatis Mariae Curie-Skłodowska: “Blood lipids profile in obese or overweight patients.”

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