Syringe of blood over a list of possible blood test

What is Cholesterol?

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Cholesterol is a fat-like substance (lipid) that is made in the liver from the foods you eat.

You need cholesterol for your body to function properly. Cholesterol is found in every cell in your body, and is needed to produce cell membranes, hormones, vitamin D and bile acids that help to digest fat. It is vital for brain and nerve functioning and helps in the formation of memories. Cholesterol harms your health only if it becomes excessive.

High blood cholesterol increases your risk of cardiovascular diseases such as heart disease and stroke. If you have diabetes and high blood cholesterol, your risk for these diseases is even higher.

Related: Cholesterol and Your Heart  

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How Does Diabetes Affect My Blood Cholesterol?

Diabetes worsens your blood cholesterol levels (lipid profile)[1] by:

  • lowering the blood levels of “good” cholesterol (high-density lipoprotein or HDL)

  • raising the blood levels of “bad” cholesterol (low-density lipoprotein or LDL)

  • raising the blood levels of fat particles (triglycerides)

As cholesterol is not water soluble, it has to be carried around the body. Lipoproteins are carriers of cholesterol. We can think of lipoproteins as taxis moving around the blood stream and picking up cholesterol. Similarly, triglyceride needs to be carried by lipoproteins too.

Cholesterol and Lipoprotein 
  • HDL picks up excess cholesterol and removes it from your blood so that cholesterol does not build up on blood vessel walls and block blood flow to important organs. Having higher levels of HDL cholesterol lowers your risk of cardiovascular disease. That is why HDL cholesterol is labelled as “good” cholesterol.

  • LDL, on the other hand, keeps excess cholesterol in the blood where it builds up slowly to form plaque. Plaque attracts clot formation and causes hardening and narrowing of blood vessels. It is “bad” because higher levels of LDL cholesterol can increase risk of cardiovascular diseases.

  • Triglycerides are a natural form of fat made by your body from the foods you eat. Too much triglycerides in the blood is also a risk factor for cardiovascular disease.

Related: Blood Glucose Monitoring

What Can I Do to Improve My Blood Cholesterol?

  • Check your blood cholesterol every year[2]. If you are taking cholesterol-lowering medications or if you have additional cardiovascular risk factors (overweight, high blood pressure, smoking habits), you may need more frequent tests.

  • Control your blood cholesterol. Good diabetes care requires tight control of blood glucose, blood cholesterol and blood pressure.

    Most doctors would recommend that you lower LDL cholesterol, aiming for a level lower than 2.6 mmol/L2. In addition to taking cholesterol medications as prescribed, maintaining a healthy weight, adopting healthy eating habits and exercising regularly also help you manage cholesterol and lower your risk of getting cardiovascular disease.

    However, if you have had diabetes for less than ten years and do not have additional cardiovascular risk factors, your doctor may suggest you try changing your lifestyle before prescribing medications.

    Here are some tips for a healthy lifestyle:

Healthy Lunch 

Healthy eating habits

Weight 

Healthy weight

  • Check your weight and waist circumference

  • If you are overweight, losing 5 to 10 percent of your current body weight through healthy eating and regular physical activity can improve your cholesterol levels.

Man Swimming In The Pool 

Regular physical activity

  • Aim for at least 150 minutes of exercise each week. This can be done as one 30-minute session or three 10-minute sessions a day, five days per week, together with resistance exercise two or more times per week.

  • Ask your healthcare provider for advice on how to get started and to stay active.

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References

  1. Krauss, R. M. (2004 Jun). Lipids and Lipoproteins in Patients With Type 2 Diabetes. Diabetes Care. 27(6), 1496-1504.
    Retrieved from http://care.diabetesjournals.org/content/27/6/1496

  2. Ministry of Health (2012, Oct 2). Clinical Practice Guidelines [Website].
    Retrieved January 2014 from https://www.moh.gov.sg/content/moh_web/home/Publications/guidelines/cpg.html