Cholesterol, Heart Disease and Diabetes

A special content area from the editors of Diabetes Forecast.

Cholesterol is a fatlike substance that serves several useful functions. Your liver makes cholesterol, and you get some from your diet. Cholesterol travels around the body in tiny clumps of fat and protein called lipoproteins. Low-density lipoproteins (LDL) carry cholesterol where it is needed. High-density lipoproteins (HDL) carry leftover cholesterol back to the liver.

When cholesterol levels are high, LDL dumps it in arteries, where it builds up in hard lumps called plaques. For good blood flow, blood vessels need to be flexible and free of plaques. Cholesterol buildup in arteries makes them rigid (“hardening of the arteries”) and narrower. The result: high blood pressure, blood clots, even heart attacks and strokes. Luckily, HDL carts away from arteries some of the cholesterol LDL leaves there. For these reasons, it's healthiest to have low LDL cholesterol levels and high HDL cholesterol levels.

Diabetes can upset the balance between HDL and LDL levels.

• People with diabetes tend to have LDL particles that stick to arteries and damage their walls more easily.




• Glucose (a type of sugar) latches onto lipoproteins. Sugar-coated LDL remains in the blood-stream longer and may lead to plaques.




• People with diabetes tend to have low HDL and high triglyceride (another kind of blood fat) levels, both of which boost the risk of heart and artery disease.

As a result, in people with diabetes:

• Heart disease occurs earlier.
• Heart disease is two to four times as common.
• Heart disease is more often fatal.

Heart disease in people with diabetes is a major public health problem, one that is expected to get worse. A Centers for Disease Control and Prevention study estimated that one-third of babies born in 2000 will someday develop diabetes.

People can reduce their risk of heart and blood vessel disease by lowering their cholesterol levels.