People who have diabetes often have high cholesterol as well, and this is a dangerous combination. According to the American Heart Association, adults with diabetes are two to four times more likely to have heart disease or a stroke than someone who does not have diabetes. In fact, those are the most common causes of death among people with diabetes.

What Is cholesterol?

Cholesterol is a waxy, fatty substance that’s made in your liver and travels through your bloodstream. Your body needs some cholesterol to function properly, but the body produces what it needs. Cholesterol is carried around in your blood by lipoproteins.

Low-density lipoprotein (LDL), also called “bad” cholesterol, moves cholesterol to your body’s tissues and through blood vessels. If there is too much LDL, it will build up along the walls of your blood vessels, which can reduce blood flow and contribute to heart disease.

High-density lipoprotein (HDL), also called “good” cholesterol, takes cholesterol from your body’s tissues and blood vessels and brings it to your liver where it’s removed from the body. Good cholesterol helps protect you from LDL buildup, so if your HDL levels are low, your risk for heart disease is higher.

Triglycerides are another type of fat that can build up in your body. If triglycerides are high in addition to low levels of HDL cholesterol, it raises your risk for heart disease.

What’s the connection?

Having diabetes lowers your HDL, and raises your LDL cholesterol and triglyceride levels. This is because cholesterol is affected by high blood sugar and high blood pressure, two conditions linked to diabetes.

When you have diabetes, your body isn’t able to properly regulate blood sugar. The excess sugar (glucose) attaches to LDL, which then causes LDL cholesterol to stay in your blood for longer than it would otherwise. More LDL puts you at risk for developing buildup in your blood vessels that can lead to blockages, causing a heart attack or stroke.

Cholesterol numbers and diabetes

The goals for managing cholesterol are to lower your LDL and triglycerides counts, and to increase your HDL count. If you have diabetes, your doctor will likely recommend that you aim to get your LDL and triglycerides even lower than the average levels recommended for good heart health.

Here are the target numbers for people with diabetes, as recommended by the National Institutes of Health (NIH):

  • Total cholesterol: under 200 mg/dL
  • LDL: under 100 mg/dL, and under 70 mg/dL if you already have heart disease
  • HDL: over 40 mg/dL in men and over 50 mg/dL in women
  • Triglycerides: under 150 mg/dL

Depending on your individual health needs, your doctor may tell you to aim for different numbers. Managing your cholesterol levels is important to protect your heart health. People with diabetes should have their cholesterol checked at least once a year.

thumbs up Daily diabetes tip
  • What are the most common causes of death among people with diabetes? According to the American Heart Association, they are heart disease and stroke. The best way to safely steer clear is to keep a watchful eye on your “bad” cholesterol, which can otherwise reduce healthy blood flow.

What you can do

In addition to taking medications that your doctor prescribes, such as statins, there are lifestyle changes you can make to improve your cholesterol levels. Many of these will also help with controlling blood sugar and blood pressure.

1. Maintain a healthy weight.

If you are overweight, losing even a few pounds can have a positive impact when it comes to managing blood sugar, blood pressure, and cholesterol. Talk to your doctor about your weight loss goals and what your target weight should be.

2. Get moving.

Exercise is a powerful tool for weight loss and lowering cholesterol. Experts recommend getting 30 to 60 minutes of moderate physical activity almost every day of the week. Activities such as brisk walking, bike riding, dancing, playing sports, jogging, or swimming will all give you cardio benefits. Aerobic exercise also helps raise your good cholesterol levels.

3. Change your diet.

You’ll already need to make dietary changes in order to maintain your blood sugar levels. You can lower LDL cholesterol by reducing the saturated fat and trans fats in your diet and increasing dietary fiber. If you’re not taking in high amounts of saturated fat, you’re not producing the material needed to boost cholesterol. Replace saturated fats with healthy unsaturated fats like olive oil, nuts, and avocado. Get fiber by eating whole grains instead of white bread and rice. Foods that are high in fiber are also helpful in preventing blood sugar spikes.

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4. Quit smoking.

Smoking increases your risk for heart disease and causes complications with diabetes. If you’re a smoker, talk to your doctor about a quitting strategy. It’s never too late to make a positive change.


Making positive changes and staying on top of your health will help you maintain control of your diabetes and reduce your risk for heart disease. If you’re unsure about how to start making lifestyle changes, speak with your doctor or ask to see a dietician. They can work with you to develop a plan that will meet your needs.