Diabetes and cholesterol

It is helpful to have a general knowledge about cholesterol before reading this article on cholesterol in diabetes. Click here to link to general cholesterol articles.

The Centers for Disease Control and Prevention report that 70-97% of people with diabetes have dyslipidemia (a problem with one or more lipid levels). The common dyslipidemia in diabetes is low HDL and high triglycerides. The LDL level in diabetes does not differ significantly from those without diabetes. However, with diabetes, there can be changes in the lipid substance itself, besides changes in the quantity of the lipid level. When diabetes is present, LDL particles become smaller and denser. These smaller, denser particles are more damaging to blood vessel walls, and are more easily used for plaque formation. Smaller, denser LDL particles accelerate the process of atherosclerosis. HDL particles also undergo a change, making them less able to carry LDL back to the liver. Thus, HDL particles become less protective. High triglyceride levels contribute to the formation of small, dense LDL particles, and reduced amounts of HDL. High triglycerides often accompany high blood sugar levels, and when blood sugar levels are returned to more normal levels, triglycerides usually improve.

Diabetic dyslipidemia refers to this triad of lipid problems: high triglycerides, low HDL, and smaller, denser LDL particles that may or may not be at a higher level. As with people without diabetes, the first priority for treatment is to reduce LDL if it is elevated. Normalizing blood sugars is also a priority and will help improve lipids, particularly triglycerides.