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Are You at Risk?

People with diabetes are at high risk for heart disease. The newest government guidelines for cholesterol management released by the National Cholesterol Education Program, nicknamed ATP III, put people with diabetes in the highest risk category.

Unfortunately, many people are unaware of their risk. Heart disease is one of the most serious diabetes complications, accounting for the majority of diabetes-related deaths. Yet an American Diabetes Association (ADA) survey of people with diabetes found that more than two thirds (68%) of people with diabetes do not consider heart disease to be a serious complication of diabetes. In fact, heart attacks occur at an earlier age in people with diabetes and often result in premature death.

The survey also found that sixty percent of people with diabetes surveyed do not feel at risk for cholesterol problems. Yet research has shown that nearly all people with diabetes have one or more cholesterol problems, such as increased triglycerides, low HDL ("good") cholesterol, or elevated LDL ("bad") cholesterol.

ADA recommends that doctors measure total cholesterol, LDL cholesterol, HDL cholesterol and triglycerides in adults with diabetes at least once a year. LDL cholesterol is more important than total cholesterol for telling whether someone has unhealthy fat levels.

ADA has set the following goals for blood lipids.

  • LDL cholesterol should be below 100 mg/dL.
  • HDL cholesterol should be greater than 50 mg/dL in women and 40 mg/dL in men.
  • Triglyceride levels should be less than 150 mg/dL.

ADA recommends taking action when LDL cholesterol levels are 100 mg/dL or higher. Generally, lifestyle changes such as losing weight, becoming more active and improving diet with the help of a dietitian (medical nutrition therapy) are the first steps. If LDL cholesterol is still too high, the person should continue with these steps and start taking a cholesterol-lowering drug.

However, people who already have heart disease or who have high LDL cholesterol levels (200 mg/dL or higher) may need to start taking drugs right away.



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