What is Cholesterol?
Cholesterol is a soft, waxy substance found among the lipids (fats) in the bloodstream and in all cells. Cholesterol comes in several forms, most notable of which are "good" and "bad" cholesterol.
High levels of low-density lipoprotein (LDL), aka "the bad cholesterol," can increase your risk of heart attacks or stroke. LDL is the major cholesterol carrier in the blood and it can form a plaque on the inside of arteries, which is a condition known as atherosclerosis. If a clot forms and blocks blood from flowing to the heart muscle, a heart attack can occur. If a clot blocks the flow of blood to the brain, a stroke results. Keeping your LDL low helps to protect your heart.
By contrast, high-density lipoprotein (HDL) is considered "the good cholesterol" because high levels seem to protect against heart attacks. About one-third to one-fourth of blood cholesterol is carried by HDL. It helps remove plaque deposits from the walls of the blood vessels, preventing blockages.
Triglycerides are another type of fat that circulates in the bloodstream. High triglycerides raise your risk of a heart attack or stroke.
The National Diabetes Education Program (NDEP) recommends that diabetes patients maintain cholesterol levels of:
- LDL (bad cholesterol) < 100 mg/dl (and <70 mg/dl for those considered "very high risk")*
- HDL (good cholesterol) > 40 mg/dl in men and >50 mg/dl in women
- Triglycerides < 150
*The National Cholesterol Education Program defines very high-risk patients as those who have cardiovascular disease together with either multiple risk factors (especially diabetes), or severe and poorly controlled risk factors (e.g., continued smoking), or those with acute coronary conditions such as heart attacks.
Treatment of Elevated Cholesterol
High cholesterol levels are a major risk factor for coronary heart disease, which is an increased concern for people with type 1 diabetes. What can you do if you have high cholesterol? Here are some lifestyle changes you can implement to help lower your cholesterol:
- First and foremost, keep your blood glucose levels under control.
- Work with your medical team to develop a meal plan that you can stick with
- Eat more healthy fats (from fish and plant foods) and avoid trans fat (found in processed foods)
- Eat more fruits and vegetables
- Choose whole grains for cereals and breads
- Get at least 30 minutes of moderate intensity exercise per day
- If you smoke – quit!
- Maintain a healthy weight
- If you have elevated triglycerides, take fish oil supplements (under a physician's care)
When it comes to cholesterol, careful monitoring and healthy lifestyle changes are key. However, sometimes changing your diet or your weight isn't enough. There are times when drug therapy is prescribed to achieve results.
Excerpted and adapted from The American Heart Association.
- American Heart Association. Drug Therapy for Cholesterol. http://www.heart.org/HEARTORG/Conditions/Cholesterol/PreventionTreatmentofHighCholesterol/Drug-Therapy-for-Cholesterol_UCM_305632_Article.jsp. (Accessed 6/26/11).
- FDA. High Cholesterol — Medicines to Help You. http://www.fda.gov/ForConsumers/ByAudience/ForWomen/ucm118595.htm. (Accessed 6/26/11).
- Pharmacist's Letter. http://pharmacistsletter.therapeuticresearch.com/home.aspx?cs=&s=PL&AspxAutoDetectCookieSupport=1 (Accessed 5/13)
- U.S. Food and Drug Administration. FDA Approves Combination Therapy Juvisync. http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm274748.htm. (Accessed 10/7/11.)
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As I mentioned in an earlier post, one of the benefits that made it cost-effective for me to go with the real healthcare (HSA) plan rather than the phony (HRA) plan is that my company is now covering "preventative" medicines at $0 copay. The formulary for these, as stated by CVS/Caremark (my pharmacy benefits provider), covers all test strips, lancets, and control solutions. I dutifully get my doctor to write up prescriptions for all of my testing needs, submit...