Cholesterol Treatment Goals for Patients with Diabetes

Cholesterol is a type of fat (also called lipid) discovered in the blood naturally. It is produced by the liver and absorbed from some of the foods in our diet. It is a wax or oil-like substance and does not mix with the blood (water-based) discovered in every body cell.

Diabetes tends to lower “good” cholesterol levels and raise the “bad” cholesterol levels which increase the risk for heart disease and stroke. Especially, watching your diet is critical when you have diabetes and high cholesterol. Please refer to the types of cholesterol here.

Patients with Diabetes often require lipid-lowering therapy. Glucose reduction alone, which may account for some improvement in lipid levels, is often not enough to reduce the excess cardiovascular risk faced by patients with Type 2 Diabetes.

In fact, diabetes is considered to be a cardiovascular risk equivalent, meaning that a patient with diabetes and no cardiovascular disease has the same risk of experiencing a future cardiovascular event as does a person with established cardiovascular disease.

The lipid goals published by the National Cholesterol Education Program ATP III reflect this concept; “For patients with patients diabetes without coronary heart disease, the LDL cholesterol goal <100 mg/dL (The same as for a person with coronary heart disease).

Must Read: Diabetes and Lipid Metabolism

The guidelines are well explained in below. It describes the NCEP ATP III and ADA guidelines for patients with diabetes for LDL cholesterol goals, LDL cholesterol levels for initiation of lifestyle interventions, and LDL cholesterol levels for pharmacologic therapy. The NCEP ATP III and ADA guidelines are not exactly the same, but they are similar.

Guideline 1 – NCEP ATP III: Patients with diabetes with or without cardiovascular disease

  • LDL Cholesterol Goal: Less than 100 mg/dL
  • LDL Cholesterol Level to initiate therapeutic Lifestyle changes: Greater or equal to 100 mg/dL
  • LDL Cholesterol Level to initiate Pharmacologic therapy: Greater than 100 mg/dL (Initiated simultaneously with lifestyle intervention)

Guideline 2.a – ADA: Patients with diabetes and no cardiovascular disease

  • LDL Cholesterol Goal: Less than 100 mg/dL
  • LDL Cholesterol Level to initiate therapeutic Lifestyle changes: Greater than 100 mg/dL
  • LDL Cholesterol Level to initiate Pharmacologic therapy: Greater than 100 mg/dL (If lifestyle modification is inadequate)

Guideline 2.b – ADA: Patients with diabetes and cardiovascular disease

  • LDL Cholesterol Goal: Less than 100 mg/dL
  • LDL Cholesterol Level to initiate therapeutic Lifestyle changes: Greater than 100 mg/dL
  • LDL Cholesterol Level to initiate Pharmacologic therapy: Greater than 100 mg/dL (Initiated simultaneously with lifestyle intervention in patients with diabetes and clinical cardiovascular disease)

Excess fat is stored as adipose tissue and contributes to obesity. Excess fat (i.e. obesity) is a risk factor for type-2-diabetes. Some research suggests that the compartment of fat called visceral fat puts patients at higher risk for developing type-2-diabetes and cardiovascular disease than a subcutaneous fat deposition.

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