If you are diabetic, you have a higher risk of heart disease and stroke. This is because diabetes tends to lower the good cholesterol in your body and raise the bad cholesterol, which is called LDL. The result is that your arteries get clogged with fat and other substances. Insulin resistance and high cholesterol may already be developing long before you are diagnosed with diabetes, according to the American Heart Association. Learning to prevent cholesterol problems and reduce high cholesterol is a critical part of diabetes management.
What is LDL Cholesterol?
Cholesterol is a soft, waxy, fat-like substance. It travels through the body in molecules called lipoproteins. Your liver and your brain produce cholesterol for many important body functions, but Americans also get too much of the bad form of cholesterol--low-density lipoprotein, or LDL--from eating foods high in saturated fat. LDL is bad because it mixes with other substances and forms plaques on the walls of your blood vessels. This makes your veins stiffer and narrower. This condition is called atherosclerosis and it makes it harder for blood to get through. Moreover, the plaques can fall off, form clots and block blood flowing to your heart and brain. People with diabetes are more likely to have elevated LDL, which can progress to cardiovascular disease and an early death if not treated properly.
LDL in Diabetes
An important part of managing diabetes is trying to reduce your risk of getting, and dying from, heart disease. Prevention of heart disease is better than treating it. As a diabetic, you need to have your cholesterol profile checked regularly, eat a heart-healthy diet and take medications properly if you have heart disease. One of the most insidious factors of LDL in diabetics is that it may appear to be within the normal range. However, according to research published in the January 2008 issue of "Clinical Diabetes," diabetics actually have a more dangerous form of LDL. The LDL particles are smaller, denser and contain less cholesterol than normal sized LDL particles. However, these smaller particles are "exceptionally atherogenic," or artery-clogging. In addition, because diabetes often results from obesity, LDL can interact with the features of metabolic syndrome, which magnifies your risk of heart disease.
Cholesterol and the Diabetic Brain
Your brain uses more cholesterol than any other organ in your body. If you have diabetes, your body limits how much cholesterol your brain can make. Neurons in your brain use cholesterol to form connections with other cells. This process affects functions like appetite control, behavior, memory, pain and motor activity. If your brain is not getting enough cholesterol or experiences a problem in metabolizing it, the defect results in problems like Alzheimer's disease and other neurodegenerative conditions. The problem also manifests in overeating and weight gain, creating a vicious cycle in the experience of diabetes.
Improving Cholesterol Levels
If you have diabetes, your LDL goal should be less than 100 mg per deciliter, or mg/dL, measured in your blood. Officials at Harvard University's Joslin Diabetes Center recommend that if you have already been diagnosed with heart disease, you should strive to keep your LDL below 70 mg/dL. They also say that diabetics can reduce their heart-related complications by 20 to 50 percent by lowering LDL. The American Diabetes Association advises that you get your cholesterol checked at least every five years. You can also improve your LDL levels if you quit smoking, lose weight, exercise daily, eat a low-fat diet and increase your intake of monounsaturated fats--like canola and olive oils. Joslin also advises you to increase consumption of plant sterols--found in wheat germ, wheat bran, peanuts, vegetable oils, almonds and Brussels sprouts. Plant sterols prevent the absorption of cholesterol in your intestines. You also need to take your medicine to control your cholesterol if your doctor prescribes it.
References
- American Heart Association: Cholesterol Abnormalities & Diabetes
- American Diabetes Association: All about Cholesterol
- Science Daily: Diabetes May Clamp Down on Cholesterol the Brain Needs
- Reuters: Cholesterol Drugs Up Diabetes Risk Slightly: Study
- ABC News: ACCORD Study: Cholesterol, BP Control Does Little Good for Diabetics
- Clinical Diabetes: LDL Cholesterol Lowering in Type 2 Diabetes: What Is the Optimum Approach?
