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Lowering LDL Cholesterol to Manage Your Diabetes

Cholesterol is the C in the diabetes ABCs, but this subject can be a little complicated. Cholesterol is essential for a number of cellular functions, playing important roles in building and maintaining cell membranes, synthesizing bile for fat digestion, manufacturing vitamin D, and building certain hormones.

Cholesterol is ferried around in your bloodstream by special carriers called lipoproteins, and these lipoproteins come in assorted varieties. Low-density lipoproteins, abbreviated LDL (and commonly called bad cholesterol), circulate in the blood to deliver necessary cholesterol to cells around your body.

There’s nothing bad about that; however, there’s a limit to how much cholesterol your cells require, and when that limit is reached your cells close down the receiving department. When cells won’t take delivery of more cholesterol, LDL cholesterol continues circulating in the bloodstream where an inflammatory immune response can make it more likely that LDL particles accumulate inside of artery walls, forming waxy plaques.

This process is called atherosclerosis, and it’s the principal cause of heart and cardiovascular disease.

High-density lipoproteins, HDL (commonly called good cholesterol), seem to collect excess cholesterol from your blood, thereby reducing the risk for atherosclerosis. Target cholesterol values aimed at reducing your risk for heart disease, therefore, look at both LDL and HDL. Your medical team looks to lower your LDL while raising HDL levels with medication, exercise, and diet. With diabetes, these cholesterol targets are as follows:

  • LDL levels less than 100 mg/dl (often less than 70 mg/dl if other risk factors are elevated)

  • HDL levels greater than 40 mg/dl for men, and greater than 50 mg/dl for women

  • Triglycerides, another blood fat, should be less than 150 mg/dl

Similar to blood glucose control and high blood pressure, lifestyle choices, like regular physical activity and not smoking, go a long way in keeping your LDL lower and your HDL higher. Diet plays a key role as well, and you should be seeing a consistent pattern by now about how these same lifestyle choices preserve your health on several fronts.

Objective number one for controlling cholesterol is to reduce saturated fat in your diet and eliminate trans fat. That’s why healthy diets, including the eating plan that help you manage blood glucose levels, encourage lean cuts of meat and healthy cooking methods like baking, broiling, grilling, or steaming, which don’t add fat.

Highly processed meats that are high in fat should be eaten in moderation, and trans fats should be avoided because they raise LDL and lower HDL.

Healthy eating isn’t completely about what you shouldn’t eat, but is equally about what you should eat. For cholesterol management, eat soluble fiber, like the fiber in oats, beans, and barley, and eat lots of fruits and vegetables, especially the leafy greens.

Unless there’s a reason your doctor says you shouldn’t, have alcohol in moderation to help raise HDL. And fish, which is high in omega-3 fatty acids, can raise HDL and make an enviable dinner.

Insulin resistance (including type 2 diabetes), high blood pressure, and high levels of LDL cholesterol are key elements of a broadly defined medical condition known as the metabolic syndrome.

Although people with metabolic syndrome may not have diabetes, these and other abnormalities associated with metabolic syndrome — such as an increased tendency to form clots and evidence of increased inflammation — are all associated with increased heart attacks. Improvement in lifestyle with a better diet and more exercise is the first step in reversing metabolic syndrome, just as it is for diabetes.

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