Patient Guide to Treating High Cholesterol and Diabetes

Cholesterol Basics

Good Cholesterol, Bad Cholesterol: What’s It All Mean for You?

Before we get too far into hyperlipidemia—high cholesterol in the blood—we should have a grounding in what cholesterol is and what it does.  Cholesterol is a fat-like substance (often, it’s referred to as “waxy”) that’s used by your body to make vitamin D, hormones, and substances that aid in digestion.  It is necessary for your body to function properly.

Your body actually makes most of the cholesterol you need, although you do get some of it from what you eat.  Cholesterol is made in the liver.

You have two kinds of cholesterol, and you’ve probably heard of these before:  “good” cholesterol and “bad” cholesterol.

Both kinds of cholesterol travel through your blood as lipoproteins:  you can think of them as little packages being sent around your body.  On the inside of the package, there are fats (the cholesterol) and on the outside, there are proteins.

But which kind of cholesterol is good and which is bad—and why does it matter?

Good Cholesterol
High-density lipoproteins (HDL) are the “good” cholesterol.  These little packages are more dense, and part of their job is to escort cholesterol from other parts of your body back to your liver—where it’s then removed.

HDL cholesterol is good, then, because it gets the cholesterol out of the bloodstream (too much cholesterol in the blood in hyperlipidemia, remember).  Once the cholesterol is back in the liver, it’s broken down and removed from your body.

You should have a high level of HDL, the “good” cholesterol.

Bad Cholesterol
Low-density lipoproteins (LDL) are the “bad” cholesterol.  These carry cholesterol from your liver to other cells in your body—and therein lies the problem.  LDL can carry too much cholesterol (more than is needed by the cells), and then cholesterol will build up in the blood.

Built-up LDL can start to cause blockages in arteries by forming plaque, which restricts blood flow.

You should have a low level of LDL, the “bad” cholesterol.

And Don’t Forget about Triglycerides
Triglycerides are part of your overall lipid profile—how much fat is in your blood.  Any calories your body doesn’t use right away from food are converted into triglycerides, which are stored in fat cells and used later.

When taking into account your overall cardiovascular health, triglycerides are important.

Optimal Cholesterol Numbers
As someone with diabetes, you should carefully monitor your lipid profile.  (Really, everyone should, but it’s especially important if you have diabetes.)

According to the American Heart Association1, your levels should be:

  • Total Cholesterol:  Less than 200 mg/dL
  • HDL (Good) Cholesterol:  Higher than 40 mg/dL for men and higher than 50 mg/dL in women is very good, but if your HDL level is 60 mg/dL or higher, your risk of heart disease will be significantly lower.
  • LDL (Bad) Cholesterol:  Less than 100 mg/dL
  • Triglycerides: Less than 150 mg/dL

How Often Should You Have Your Cholesterol Tested?
The National Cholesterol Education Program recommends that everyone aged 20 and older should have a fasting lipoprotein profile (lipid profile) done every 5 years2.  Your doctor may recommend a different timeline, given your health and history.

This is a fasting test, as the name suggests:  you need to go 9 to 12 hours without food, liquids, or pills before the test.

Cholesterol Is Important to Your Health
As you can see, cholesterol—and having healthy cholesterol levels—is important to your overall health, especially when you have diabetes and want to avoid cardiovascular complications.

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Diabetes and Cardiovascular Risk