Most adults with type 1 or type 2 diabetes are at high risk for cardiovascular diseases such as heart attack and stroke.

People with diabetes have an increased risk of these diseases even if their low-density lipoprotein, or LDL ("bad") cholesterol, is “normal.” They have an even higher risk if their LDL-cholesterol is elevated.


Cardiovascular disease: Damage to the heart and blood vessels. One cause is narrowing of the blood vessels due to fat deposits on the vessel walls, which limits blood flow.

Cholesterol: A fat substance that is naturally present in your blood and cells. There are two main types of cholesterol: LDL and HDL.

  • LDL (low-density lipoprotein): Often called “bad” cholesterol because higher levels of LDL can increase the risk of cardiovascular disease.
  • HDL (high-density lipoprotein): Often called “good” cholesterol because higher levels of HDL can reduce the risk of cardiovascular disease.

Triglyceride: A form of fat that the body makes from sugar, alcohol or other food sources.

Have you had your cholesterol tested lately?

Adults with diabetes should have their cholesterol tested yearly or as indicated by your health-care provider. More frequent testing may be necessary for people taking cholesterol medications. Always discuss your cholesterol results with your doctor and other members of your health-care team.

Have you been told that you have high cholesterol?

High cholesterol usually refers to high LDL (“bad”) cholesterol. The main goal is to lower LDL-cholesterol. Check with your health-care provider to find out if you should be on medication to accomplish this. Weight management, healthy eating and regular physical activity will also help you reach this goal.

Diabetes management requires good blood glucose (sugar), blood pressure and cholesterol control.

How can you manage your cholesterol through lifestyle choices?

In addition to taking cholesterol medications as prescribed, being at a healthy weight, having healthy eating habits and doing regular physical activity help you manage cholesterol and reduce your risk of developing cardiovascular disease.

Your main goal should be to lower LDL-cholesterol, targetting for 2.0 mmol/L or lower.

Healthy eating tips

Here are some healthy eating tips to help you manage your cholesterol:

  • Choose lower-fat foods
  • Limit saturated fats
  • Avoid trans fats
  • Limit food sources of cholesterol
  • Choose high-fibre foods

To help lower LDL cholesterol, replace saturated and trans fats with small amounts of unsaturated fats, such as:

  • Olive oil
  • Canola oil
  • Peanut oil
  • Nuts and seeds such as peanuts, almonds and ground flax
  • Soft non-hydrogenated margarine

Make healthier choices from each of the food groups:

Milk & alternatives
  • Choose lower-fat milk (such as skim or 1%) and milk products (such as low-fat yogurt)
  • Choose low-fat milk alternatives such as soy- or rice-based products
Grains & starches
  • Choose whole grains
  • Choose high-fibre grains, especially those with soluble fibre (such as barley, brown rice, multigrain pasta)
  • Choose low-glycemic index foods
  • Choose whole and unprocessed fruit for more fibre
  • Choose a variety of colours
  • Choose high-fibre vegetables
  • Choose fresh vegetables, if possible
Meat & alternatives
  • Choose at least two meals per week of fatty fish (such as salmon, trout, sardines)
  • Choose plant protein more often (such as tofu, legumes, lentils)
  • Choose lean meats, trim visible fat, remove skin from poultry
  • Choose lower-fat cheese (less than 20% milk fat [MF])

You can also look at the nutrition facts label to make healthy food choices. Learn more about understanding the nutrition label.

Body size

A healthy weight is assessed in many ways. Ask your health-care team about your body mass index (BMI), waist measurement and weight goals.

It is a fact that you are at a higher risk if you carry most of your weight around the abdomen.

If you are overweight, losing five to 10 per cent of your current body weight through physical activity and healthy eating can help improve your cholesterol levels.

Here is a list of items you can keep track of:

  • BMI
  • Target BMI
  • Waist measurement
  • Target waist measurement
  • Current weight
  • What would equal to a five to 10 per cent weight loss

Physical activity

Regular physical activity can help with your overall diabetes management and improve your cardiovascular health. Aim for at least 150 minutes per week such as one 30-minute session or three 10-minute sessions a day, five days per week and resistance exercise two to three times per week.

Ask your health-care team for tips on how to get started and how to maintain regular physical activity.

Are you doing all you can to lower your LDL?

Are you ready to do more for your cardiovascular health? Review your LDL-lowering goals before moving on to the next steps:

  • I am taking my cholesterol medication(s) as prescribed by my doctor.
  • My weight is in the healthy range.
  • My waist measurement is in the healthy range.
  • I have healthy eating habits:
    • I eat enough vegetables and fruit servings every day.
    • I make high-fibre choices (such as whole grains).
    • I limit cholesterol-containing foods.
    • I choose low-fat foods and avoid saturated and trans fat.
  • I am physically active on a regular basis.

If you answered YES to all the above, it means you are on the right track. If you answered NO to one or more of the goals, decide what steps you are ready to take.

If your triglyceride level is very high, your doctor may suggest you lower it with medications and lifestyle choices. The following can help improve your triglyceride level:

  • Limit alcohol intake
  • Achieve and maintain excellent blood glucose (sugar) control
  • Achieve and maintain a healthy weight
  • Limit added sugar and low-fibre foods such as regular pop, candy, sugar-sweetened cereals