Diabetics at increased risk for heart disease

Nearly all people with diabetes have abnormal cholesterol levels, which contribute to their increased risk for heart attack and stroke.

With diabetes, heart attacks occur earlier in life and often result in death.

To lower your risk, you need to take action today and lower your cholesterol levels.

What is cholesterol?

Cholesterol is a waxy, fat-like substance that is in all the body’s cells, including the blood. It is critical in building cells and in creating certain hormones.

Your body makes all of the cholesterol it needs. Cholesterol is also found in some food you eat. Cholesterol can’t dissolve in the blood. It needs to be carried from cell to cell by carriers called lipoproteins. There are two types of lipoproteins.

Low-density lipoprotein (LDL) is known as “bad” cholesterol. High-density lipoprotein (HDL) is known as “good” cholesterol.

These two, along with triglycerides, make up your total cholesterol count, which can be determined through a blood test ordered by your doctor.

How does cholesterol work?

LDL cholesterol circulates in the blood and slowly builds up in the inner walls of the arteries. High levels of LDL can stick to the lining of the arteries (blood vessels), leading to atherosclerosis or hardening of the arteries. Atherosclerosis “plaque” is a thick, hard deposit that can narrow the arteries and make them less flexible. If the arteries that supply the heart and brain with blood become blocked with plaque a heart attack or stroke can occur.

HDL cholesterol also circulates in the blood, but its job is to protect against heart attack.

Medical experts think that HDL helps the body by carrying LDL away from the arteries and back to the liver, where it’s passed from the body. Some experts also believe that HDL removes excess cholesterol from arterial plaque, therefore slowing its buildup.

Desirable lab values for LDL is less than 100mg/dl and HDL should be more than 50mg/dl.

What are triglycerides?

Triglyceride is a form of fat in the body. It provides much of the energy needed for cells to function. Calories eaten in a meal and not used immediately by your body are converted to triglycerides and transported to fat cells to be stored. High levels of triglyceride can be due to obesity, inactivity, cigarette smoking, excess alcohol consumption and a diet very high in carbohydrates (60 percent of total calories or more).

Desirable lab values for triglycerides should be lower than 150mg/dl.

Where do they come from?

Dietary cholesterol and triglycerides mainly come from eating animal products and saturated fat.

Foods such as egg yolks, meat, poultry, shellfish and whole and reduced-fat milk and dairy products contain cholesterol and triglycerides. Trans fats can also raise blood cholesterol.

Lowering LDL; raising HDL

According to the American Heart Association, the recommendation is to limit your average daily cholesterol to less than 300 milligrams a day.

If you have heart disease, they recommend limiting the daily intake to less than 200 milligrams. To lower your daily cholesterol intake, you must read the nutritional facts on the food items. By eating lean meat, fish, poultry and fat-free and low-fat dairy products, you can lower your risk of heart disease. Foods from plants (fruits, vegetables, grains, nuts and seeds) don’t contain cholesterol.

If your HDL levels are low, you are at risk for heart disease.

To raise your HDL levels, you should stay physically active, maintain a healthy weight, avoid smoking, cut trans fats and increase monounsaturated fats in your meal plan.

Monounsaturated fats include canola oil, avocado oil or olive oil.

You can also add soluble fiber such as oats, fruits, vegetables and legumes.

Kaishawn McDuffie, RN, BSN, CDE, is a registered nurse and a certified diabetes educator.