Patient Guide to Treating High Cholesterol and Diabetes

High Cholesterol Treatments

Treatment Options When You Have High Cholesterol and Type 2 Diabetes

To treat high cholesterol, your doctor will most likely first recommend lifestyle changes.  You may be asked to exercise more or to eat a more heart-healthy diet; these lifestyle modifications are considered the first line of defense when it comes to trying to get your cholesterol numbers back in line.  If, however, these changes don’t help bring down your LDL (bad) cholesterol numbers, then your doctor may suggest a medication. 

Lifestyle Changes to Treat High Cholesterol
Exercise:  If you aren’t in an exercise routine, now is the time to start.  The American Diabetes Association recommends 30 minutes of brisk walking for 5 days per week1—that is a good goal for you.  Remember:  don’t push yourself too hard initially.  Give yourself time to increase your physical activity level.

Diet:  You can make changes to what you eat every day—and have a lifelong impact on your heart health.  Try to eat more low-fat, low cholesterol food:  fresh fruits and veggies, whole grains, and fish.  You’ll learn more about this in our article on how to eat well when you have high cholesterol and diabetes.

Stop Smoking:  Your heart—and keeping it strong and healthy—can be the motivation you need to quit.

Lose Weight:  Same things as with smoking—if you’ve ever needed an extra push to lose that extra weight, use the goal of better controlling your cholesterol to keep you focused on making healthy choices.

Medications for High Cholesterol
If lifestyle changes don’t work to lower your cholesterol numbers, you may need to take a medication.  There are several options available, and your doctor will work with you to figure out the best medication for you.  The main medications used for lowering cholesterol are listed below.

Statins:  You can take these to lower LDL cholesterol as you raise your HDL (good) cholesterol.  Statins also work to lower triglyceride levels.  They work by blocking the substance in your liver that’s needed to make cholesterol.  Additionally, they may also help reabsorb cholesterol from those build-ups on your blood vessel walls.  Lipitor® and Zocor® are examples statins, but please keep this in mind:  statins tend to increase blood glucose levels, so they might not be the best option for you if you have diabetes.

Bile-acid-binding Resins:  These medications work on the bile in your liver, which is necessary for digestion.  The medication will bind to the bile, causing your liver to use excess cholesterol to make more bile acids.  If your liver is using more cholesterol, then there won’t be as much cholesterol in your blood—which reduces your cholesterol levels.  Colestid® and Welchold® are examples of bile-acid-binding resins.

Cholesterol-absorption inhibitors:  These medications reduce how much cholesterol your body absorbs from your diet.  Zetia® is an example of a cholesterol-absorption inhibitor.

  • Cholesterol absorption inhibitors. Your small intestine absorbs the cholesterol from your diet and releases it into your bloodstream. The drug ezetimibe (Zetia) helps reduce blood cholesterol by limiting the absorption of dietary cholesterol. Zetia can be used in combination with any of the statin drugs.
  • Combination cholesterol absorption inhibitor and statin. The combination drug ezetimibe-simvastatin (Vytorin) decreases both absorption of dietary cholesterol in your small intestine and production of cholesterol in your liver. It's unknown whether Vytorin is more effective in reducing heart disease risk than taking simvastatin by itself.

Lifestyle changes (diet, exercise, weight loss, smoking cessation) and medications are the main treatments used to lower high cholesterol.  Talk to your doctor about what treatments you should try.

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