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Article by Dr. Sheri Colberg, Phd, FACSM

 

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TYPE 2 DIABETES AND HIGH CHOLESTEROL


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Many people with type 2 diabetes have dangerously high levels of LDL "bad" cholesterol and fat-like substances called triglycerides that circulate in the blood stream. These elevated levels are associated with an increased risk of cardiovascular disease.

Fortunately, this risk can be reduced by managing diabetes more efficiently.

As a general rule, the higher your LDL cholesterol and triglyceride levels are and the more risk factors like diabetes that you suffer from, the higher your risk for developing cardiovascular disease and having a heart attack.

Plate of french fries.Hyperglycemia (high blood sugar) leads to an increase in LDL cholesterol by reducing the ability of the body to remove cholesterol. When blood sugars are too high, LDL cholesterol and the receptors for LDL in the liver become coated with sugar (glycosylated), impairing the liver's ability to remove cholesterol from the bloodstream.

A 2005 Angiology journal article concluded that hyperglycemia increases the formation of oxidized LDL and glycated LDL cholesterol, which are important factors in the onset of atherosclerosis (hardening of the arteries) and increased risk of death from cardiovascular disease. (1)

Elevated insulin levels have also been shown to increase LDL cholesterol and lead to atherosclerosis. Persons with diabetes can suffer from elevated levels of insulin if they eat diets rich in carbohydrates and have to dose their insulin high to combat abnormal blood sugar levels.

Diabetes puts people at especially elevated risk from cholesterol build-up in blood vessels, which restricts or even blocks circulation. So preventative action to reduce LDL cholesterol and triglyceride levels while boosting HDL "good" cholesterol level is crucial.

Slice of pizza on a plate.Cholesterol is a soft waxy fat found naturally in the cell membranes of all body tissues. It cannot be dissolved in blood and is transported in the plasma of all animals. A certain amount of cholesterol is important for cell membrane production and the creation of some hormones. But too much of the wrong kind can be fatal.

Cholesterol comes from two sources:

  • fats taken in when we eat animal products such as meat, fish, poultry, eggs, butter, whole milk and cheese.
  • our own bodies produce it - some foods contain trans-fats that cause the body to create cholesterol.

There are several other risk factors for heart diseases besides cholesterol levels. These include cigarette smoking, high blood pressure (hypertension), obesity and physical inactivity.

Inflammation - the body's defensive response to harmful stimuli - can be a factor in high cholesterol levels. In the case of diabetes, the harmful stimuli are thought to elevated levels of insulin - a classic symptom of Insulin Resistance.

If neglected over the years, inflammation can lead to serious damage to the arteries. The medical profession is still studying and evaluating the role of inflammation in a wide variety of disorders that can be inter-connected with diabetes. These disorders include the cluster of increased risks for cardiovascular disease called Metabolic Syndrome (Syndrome X) and Polycystic Ovarian Syndrome (PCOS), a leading cause of menstrual irregularity as well as skin conditions, excess facial and body hair and female baldness. To learn more, please click on Inflammation, Insulin Resistance and Diabetes.

The good news is that all these factors can be brought under control by changes in lifestyle, such as losing weight via a balanced, nutritious diet and regular exercise, as well as quitting smoking. Remember that keeping your blood sugar level under control by efficient management of your diabetes is also very important in lowering cholesterol levels.

Young woman running down a road.Add more soluble fiber (found in beans, peas and many fruits and vegetables) to your diet, as well as foods that contain omega-3 fatty acids, such as nuts and seeds, particularly walnuts, salmon, flax and plant sterols to boost your LDL cholesterol-lowering efforts.

The best way to know what's in the foods you eat is to read the nutrition label. Lower cholesterol levels start at the grocery store.

(1) A. Veiraiah. Hyperglycemia, lipoprotein glycation, and vascular disease. Angiology. 2005 Jul-Aug; 56(4): 431-8.

 

 

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