Cholesterol
Manage Your Levels
Cholesterol basics
Cholesterol is the term used for certain fats (lipids) in the blood.
LDL (low-density lipoprotein) cholesterol is the “bad cholesterol”, which deposits cholesterol on the artery and blood vessel walls. This narrows them and restricts blood flow, which increases the risk of heart attack or stroke. A high level of LDL cholesterol is very common in people with diabetes and increases their already high risk of these serious complications. For this reason, lowering LDL is the number one goal when treating high cholesterol. Canadian Diabetes Association clinical practice guidelines recommend that people with diabetes should aim for LDL levels well below what was previously considered acceptable.
HDL (high-density lipoprotein) cholesterol is “good cholesterol” because it helps remove cholesterol from the tissues. Higher HDL lowers the risk of heart disease and stroke.
Even if you don’t have diabetes, you can benefit from improving your cholesterol levels.
Know your cholesterol results and goals
Your blood lipid levels should be measured when you are first diagnosed with diabetes. You should then be tested every 1 to 3 years - or more often if you are taking cholesterol-lowering pills. Be sure to ask your doctor for your test results.
Most people with diabetes should aim for an LDL cholesterol target of 2.0 mmol/L or lower. If you are currently taking cholesterol-lowering drugs and your LDL is between 2.0 and 2.5 mmol/L, speak to your doctor about whether you should be aiming to further lower your LDL. Another marker of cardiovascular risk is the total cholesterol/HDL ratio. Ideally, this value should be less than 4.0.
Achieving cholesterol goals
People with diabetes at high risk for cardiovascular disease will require a medication called a “statin” to achieve the recommended LDL target of 2.0 mmol/L or lower. Statins are very effective at lowering LDL cholesterol and have few side effects. In addition to taking medication as prescribed, lifestyle management is an important part of achieving healthy cholesterol levels (and good overall diabetes management). If you are overweight, a weight loss of just 5 to 10% of total weight can improve your lipid profile. Regular physical activity and a meal plan low in fat (particularly saturated and trans fat) are essential. If you smoke, quit.
Lower your cardiovascular risk
The best way to lower your risk of cardiovascular disease is to address all of your risk factors. Managing your cholesterol is just as important as controlling your blood glucose and blood pressure. Talk to your doctor and healthcare team about the many ways you can lower your risk.
Lipid guidelines for people with diabetes
- LDL cholesterol target: 2.0 mmol/L or lower
- Total cholesterol/HDL target: Less than 4.0