Controlling Cholesterol Levels With Diabetes

The evidence continues to mount that controlling cholesterol is important for people with diabetes, even if they show no signs of heart disease. Having diabetes increases your risk for many diseases, including heart disease and stroke. If you have diabetes, the recommended target cholesterol levels are stricter than for those without diabetes. An adult with diabetes should have an LDL (low-density lipoprotein) cholesterol level of less than 100 mg/dl, and an HDL (or high-density lipoprotein) level of more than 40 mg/dl for men and 50 mg/dl for women. Recommended level for triglycerides is less than 150 mg/dl. In case you are unfamiliar with those terms, cholesterol is basically divided into two types, one "good" and the other "bad." LDL is often called the "bad" cholesterol because it builds up in the inside walls of arteries, causing hard lumps or plaque, the main cause of heart attacks and strokes. HDL, the "good" cholesterol, carries excess fats from your arteries and reduces this plaque buildup. So the goal is to reduce the LDL cholesterol and increase the HDL cholesterol in your blood.

If your cholesterol results are outside the recommended parameters, your doctor likely will recommend diet and exercise as a first step. If that doesn't work, the doctor may prescribe medication. One of the most important diet recommendations is to cut back on the total fat intake, especially the intake of saturated fats (found mostly in meat, milk and eggs) and trans fats (found in shortening, packaged foods and many brands of margarine).

Intake of daily cholesterol from diet should be less than 200 mg. Another important diet recommendation is to increase total fiber intake to at least 20-30 grams per day, especially soluble fiber (such as that found in oats, peas, beans, and some fruits and vegetables). Exercise can raise HDL cholesterol, as well as lower LDL cholesterol and triglycerides. In addition, exercise has cardiovascular benefits and reduces stress. However, always talk with your doctor before starting any exercise program. As for medication, a recent study in the United Kingdom found "highly significant reductions" of about 25 percent in heart attacks when people were treated with a cholesterol-reducing medication. This benefit existed in people with diabetes over the age of 40 even if their cholesterol levels were otherwise normal.

What does that mean for you? If you have diabetes, even with no signs of heart disease, cholesterol- lowering therapy may be beneficial for you. Patients should discuss this with their physicians.

Alice Pereira is a Diabetes Team Nutritionist at the South Miami Hospital, Baptist Hospital. Baptist Health South Florida is the largest faith-based, not-for-profit health care organization in the region, with an outstanding reputation for medical and service excellence. Its network of services extends throughout Miami-Dade and Monroe Counties with Baptist, Baptist Children's, South Miami, Homestead, Mariners and Doctors Hospitals, and Baptist Cardiac & Vascular Institute.