Diabetes and Cholesterol: Relationship, Diet and Drugs

To understand the relation between diabetes and cholesterol, you must first know that there are two types of cholesterol in our blood, each with a distinct function. 80% of the cholesterol is produced by the liver and the rest is obtained from the foods that we eat like egg yolk, butter, red meat, organ meat, etc.

  • Low-density lipoprotein (LDL) is the “bad cholesterol,” which carries the cholesterol through the blood stream to the various parts of the body. Cholesterol helps in the production of certain hormones and in building cell membranes and other body tissues.
  • High-density lipoprotein (HDL) is the “good cholesterol,” which carries the cholesterol from the blood to the liver to be metabolized and passed into the intestine through the bile for removal from the body.

It can be seen that LDL is responsible for the circulation of cholesterol through the blood and HDL is responsible for the excretion of cholesterol from the body.

Diabetes and cholesterol relationship

Insulin plays a pivotal role in the conversion of glucose and fats into energy. When the production of insulin falls (as in Type 1  diabetes ) or the utilization of insulin is not proper (as in Type 2 diabetes), then the conversion of glucose and fats into energy is hampered. This results in increased levels of glucose and cholesterol (fats) in the blood. It can, therefore, be seen,  why diabetes and high cholesterol are often seen together.

Cholesterol is wax – like in consistency and when its levels are increased in the blood, it tends to get deposited in the inner walls of the blood vessels forming plaques. The walls of the blood vessels get thickened, resulting in clogging of the artery. Blood glucose attaches to the LDL cholesterol and this stays longer in the blood to cause more damage.

This results in reduced blood supply to the part being supplied blood by that particular blood vessel. It can thus be, the heart or the kidney or the eye or the legs, and the problems relevant to that part occur. This is the crux of the reason of various complications arising in diabetes.

That is why people with diabetes must test themselves for fasting cholesterol levels at least once a year.

Ideal cholesterol blood levels in diabetes

  • LDL less than 100 mg/dL
  • HDL more than 40 mg/dL men and more than 50 mg/dL women
  • Triglycerides less than 150 mg/dL

Diet meal plan for diabetes and cholesterol

The best way to go about it is to eat healthy. Reduce the amount of total fats, saturated fats, trans fats, and cholesterol in your diet.

  • Choose healthy fats, which you find in nuts, seeds, fish and olive oil. Eat fish, such as salmon, mackerel, lake trout and sardines, several times week.
  • Eat a handful of nuts, especially walnuts and almonds every day.
  • Eat fruits every day. Don’t worry about the glucose in fruits. It is the fiber content we are aiming for. Soluble fiber binds with the cholesterol in the food and gets rid of it through the intestine. Fiber also slows down the absorption of carbohydrates and prevents spike in blood sugar levels. Fiber also makes you feel full for a longer time, thereby helping in weight loss. High fiber fruits include apples and pears with skins, blueberries, blackberries, strawberries, oranges and grapefruit. Fruits are also rich in antioxidants and vitamins.
  • Eat vegetables. They are a rich source of nutrients and fiber. The American Diabetes Association especially recommends sweet potatoes, spinach, kale, and collards.
  • Eat whole grains, brown bread, brown rice for the same reason.
  • Eat more of beans. Black beans, kidney beans, lima beans and other legumes do not contain cholesterol and are very low in saturated fats.
  • Have low-fat dairy products such as skim or 1% milk, fat-free yogurt, reduced fat cheese, frozen yogurt instead of ice cream.

Management guidelines for diabetes and cholesterol

  • Exercise daily. More of aerobic and less of strength training exercises.
  • Stick to the healthy diet explained above

Will you need tablets for your raised cholesterol? It will depend on four  things:

  • History of angina, heart attack or stroke — family history included
  • Any blood circulatory problems such as atherosclerosis
  • Family history of high blood cholesterol (hypercholesterolemia)
  • Diet and exercise are unable to bring down your cholesterol levels within the normal range

Drugs for diabetes and cholesterol

Medicines for diabetes are explained in this post. Aw far as cholesterol reducing drugs are concerned, your doctor is the best person to determine the course of action.

  1. Statins are the most preferred and effective drugs of the cholesterol reducing medicines in reducing LDL cholesterol and triglycerides and increasing HDL
  2. Bile acid sequestrants or Resins lower LDL by binding themselves with bile acids which contain cholesterol.

  3. Cholesterol absorption inhibitors act directly by reducing the absorption of cholesterol from the intestines, thereby lowering cholesterol blood levels.

  4. Fibrates act by stimulating extra production of an enzyme which breaks down the fats in the blood.

  5. Niacin or Nicotinic acid lowers LDL or the bad cholesterol and the triglycerides and effectively raises HDL or the good cholesterol.

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