Cholesterol and diabetes are frequent and potentially deadly companions. The American Diabetes Association says diabetics must carefully manage their cholesterol levels because doing so helps control your risk of heart disease, heart attack, stroke and other coronary heart events. According to the American Heart Association, diabetes tends to lower your good cholesterol and raise your bad. Even if you are only prediabetic, these changes in your cholesterol and other blood lipids, or fats, may already be taking place.
Cholesterol
Cholesterol is a fat-like waxy substance that helps maintain the integrity of your cells, provides raw material for many of your hormones, allows your skin to produce vitamin D, helps repair blood vessels and assists in digestion. Contrary to its unfortunate casting as public enemy number one, it's a crucial nutrient that everybody needs.
Diabetes
Diabetes is a group of metabolism disorders involving problems with the hormone insulin. Some diabetics produce little or no insulin, and others have problems of sensitivity to the insulin that is there. Insulin's job is to deliver blood sugar, your main fuel source, to your cells. As a result, diabetics can have excessive amounts of blood sugar coursing through their veins, leading to a number of serious health conditions --- one of which is disordered cholesterol metabolism.
Your Brain: A Meeting Place
A report from Harvard University's Joslin Diabetes Center says that your brain has more cholesterol than any other organ in your body. It even produces the substance on its own. Without cholesterol, your nerve cells wouldn't be able to make connections with other cells. In other words, the communication between your brain and the rest of your body malfunction. Diabetes, however, can clamp down how much cholesterol your brain can make, causing the mental and cognitive problems diabetics can experience, as well as issues with appetite, behavior and systemic nerve damage.
Your Liver: The Cholesterol -- Diabetes Hub
Your liver processes your blood sugar, and it packages about 800 to 1,500 mg of cholesterol daily, so both diabetes and high blood cholesterol involve impairments that take place in the liver. Joslin researchers say being overweight -- and most type 2 diabetics are -- and inactive, as well having poor control over your blood sugar, increases the chance you'll suffer cholesterol issues. According to University of Illinois's McKinley Health Center, your blood sugar can attach to and coat your bad cholesterol -- low-density lipoprotein, or LDL. This makes it linger in your bloodstream longer, having more opportunity to form artery-clogging plaques. People with diabetes tend to have lower amounts of the good cholesterol -- high-density lipoprotein, or HDL -- too. That's unfortunate, because good cholesterol's job is to usher bad cholesterol out of your bloodstream and back to the liver for disposal. High cholesterol is a major risk factor for heart disease, and according to Joslin, heart disease is the leading cause of death among people with diabetes.
Cholesterol Treatment in Diabetes
Being diabetic changes the way your health-care provider will treat your high cholesterol. That's because diabetes is considered a coronary heart disease "risk equivalent." This means that people who have diabetes have the same degree of risk for a major coronary event, like a heart attack, as people who have diagnosed coronary heart disease. In addition, the National Cholesterol Program, a service of the National Heart, Lung and Blood Institute, says diabetics who experience myocardial infarction die in higher rates than people without diabetes. For these reasons, cholesterol-lowering therapy is more aggressive for diabetics. If you have diabetes, your health-care provider may have a goal of getting your bad cholesterol down to lower than 100 mg/dL. As a point of reference, if you weren't diabetic, an acceptable LDL goal might be 130 mg/dL or 160 mg/dL, depending on your other risk factors for heart disease.
References
- American Diabetes Association: Cholesterol
- American Heart Association: Cholesterol Abnormalities & Diabetes
- Hepatitis A-Z: The Cholesterol Controversy; Mark Johnson
- Joslin Diabetes Center: Diabetes May Clamp Down on Brain Cholesterol; C. Ronald Kahn, M.D.; November 2010
- University of Illinois McKinley Health Center: Diabetes and Cholesterol; June 9, 2010
- National Heart, Lung and Blood Institute: High Blood Cholesterol: Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III); May 2001
