Diabetes and high cholesterol may often occur together. High blood sugar and cholesterol levels increase the risk for stroke and heart attack. But, a healthy diet and lifestyle can help you control these.

If you’ve been diagnosed with diabetes, you know that controlling your blood sugar levels is important. The more you can keep these levels down, the lower your risk of developing cardiovascular disease and other health problems.

Having diabetes puts you at a higher risk for developing high cholesterol. As you watch your blood sugar numbers, watch your cholesterol numbers, too.

Here, we explain why these two conditions often show up together, and how you can manage both with practical lifestyle approaches.

If you have both diabetes and high cholesterol, you’re not alone. The American Heart Association (AHA) states that diabetes often lowers HDL (good) cholesterol levels and raises triglycerides and LDL (bad) cholesterol levels. Both of these increase the risk for heart disease and stroke.

As a reminder:

  • An LDL cholesterol level under 100 milligrams/deciliter (mg/dL) is considered ideal.
  • 100–129 mg/dL is close to ideal.
  • 130–159 mg/dL is borderline elevated.

High cholesterol levels can be dangerous. Cholesterol is a type of fat that can build up inside the arteries. Over time, it can harden to form a stiff plaque. That damages arteries, making them stiff and narrow and inhibiting blood flow. The heart has to work harder to pump blood, and risk for heart attack and stroke go up.

Researchers don’t have all the answers yet and continue to grapple with how diabetes and high cholesterol are related. In one study published in The Journal of Lipid Research, they found that blood sugar, insulin, and cholesterol all interact with each other in the body, and are affected by each other. They just weren’t sure exactly how.

Meanwhile, what’s important is that you’re aware of the combination between the two. Even if you keep your blood sugar levels under control, your LDL cholesterol levels may still go up. However, you can control both of these conditions with medications and good lifestyle habits.

The main goal is to reduce your risk of heart disease and stroke. If you follow these seven tips, you’ll be giving your body what it needs to stay healthy and active.

You already know that it’s important to watch your blood sugar levels. It’s time to watch your cholesterol numbers, as well. As mentioned previously, an LDL cholesterol level of 100 or less is ideal. Follow your doctor’s instructions on keeping your blood sugar levels under control.

Be sure to check on your other numbers during your annual doctor visits. These include your triglycerides and blood pressure levels. A healthy blood pressure is 120/80 mmHg. The AHA suggests that those with diabetes shoot for a blood pressure of less than 130/80 mmHg. Total triglycerides should be less than 200 mg/dL.

There are some well-known lifestyle choices that clearly reduce the risk of cardiovascular disease. You probably know all of these, but just be sure that you’re doing everything you can to follow them:

  • Quit smoking or don’t start smoking.
  • Take all your medications as directed.
  • Maintain a healthy weight, or lose weight if you need to.

As someone with diabetes, you already know that exercise is key for keeping your blood sugar levels under control.

Exercise is also key for managing high cholesterol. It can help increase levels of HDL cholesterol, which are protective against heart disease. In some cases, it can also reduce levels of LDL cholesterol.

Probably the most effective exercise you can do to help control blood sugar levels is to take a walk after eating a meal.

A small New Zealand study published in Diabetologia reported that the improvement in blood sugar levels was “particularly striking” when participants walked after the evening meal. These participants experienced greater blood sugar reduction than those who just walked whenever they liked.

Walking is good for high cholesterol, too. In a 2013 study published in Arteriosclerosis, Thrombosis, and Vascular Biology, researchers reported that walking reduced high cholesterol by 7 percent, whereas running reduced it by 4.3 percent.

In addition to walking after meals, it’s also important to do some aerobic exercise for about 30 minutes daily five times a week.

In a 2014 study review published in Sports Medicine, researchers found that moderate-intensity aerobic activity can be just as effective as high-intensity types when it comes to optimizing cholesterol levels.

Try to incorporate some vigorous walking, biking, swimming, or tennis into your routine. Take the stairs, ride your bike to work, or get together with a buddy to play a sport.

Aerobic exercise is also beneficial for people with diabetes.

A 2007 study published in PLOS One reported that it helped reduce HbA1c levels in participants with type 2 diabetes. Another study published in Diabetes Care found that exercise training helped reduce waist circumference and HbA1c levels.

As we age, we naturally lose muscle tone. That’s not good for our overall health, or for our cardiovascular health. You can resist that change by adding some weight training to your weekly schedule.

Researchers in the Diabetes Care study mentioned previously reported that resistance training, or weight training, was an effective way to control cholesterol.

In a 2013 study published in the Journal of Applied Physiology, researchers found that people who had a regular weight-lifting program had more efficient HDL than those who didn’t.

Weight training is beneficial for those with diabetes too. In a 2013 study published in Biomed Research International, researchers found that resistance training helped participants build muscle. It also improved overall metabolic health and reduced metabolic risk factors for those with diabetes.

For overall health, it’s best to combine resistance training with your aerobic exercise. Researchers reported in JAMA that people who combined both types of exercise improved their blood sugar levels. Those who did only one or the other did not.

You’ve probably already made changes in your diet to help keep your blood sugar levels low. You’re controlling the amount of carbs you eat at each meal, choosing foods low on the glycemic index, and eating small meals more regularly.

If you also have high cholesterol, this diet will still work for you, with just a few small modifications. Continue to limit unhealthy fats such as those in red meat and full-fat dairy, and choose more heart-friendly fats like those found in lean meats, nuts, fish, olive oil, avocadoes, and flax seed.

Then simply add more fiber to your diet. Soluble fiber is most important. According to the Mayo Clinic, it helps to lower LDL cholesterol.

Examples of foods that contain soluble fiber include oats, bran, fruits, beans, lentils, and veggies.

Even if you’re careful about controlling both your blood sugar and your blood cholesterol, diabetes can affect other parts of the body over time. That means it’s important to stay on top of all facets of your health as you go.

  • Your eyes. Both high cholesterol and diabetes can affect your eye health, so be sure to see your eye doctor every year for a checkup.
  • Your feet. Diabetes can affect the nerves in your feet, making them less sensitive. Check your feet regularly for any blisters, sores, or swelling, and make sure that any wounds heal as they’re supposed to. If they don’t, check with your doctor.
  • Your teeth. There is some evidence that diabetes can increase risk of gum infections. See your dentist regularly and practice careful oral care.
  • Your immune system. As we age, our immune system gradually weakens. Other conditions like diabetes can weaken it even more, so it’s important to get your vaccinations as you need them. Get your flu shot each year, ask about the shingles vaccine after you turn 60, and ask about the pneumonia shot after you turn 65. The Centers for Disease Control and Prevention (CDC) also recommends that you get your hepatitis B vaccination soon after you’re diagnosed with diabetes, as people with diabetes have higher rates of hepatitis B.

Diabetes and high cholesterol can often occur together, but there are ways to manage both conditions. Maintaining a healthy lifestyle and monitoring your cholesterol levels when you have diabetes are important ways of managing both conditions.