Diabetes + High Cholesterol: The Link and How to Manage It

Good control of your diabetes can help keep your heart safe.

Loading the player...

If you have diabetes, part of your treatment regimen may include monitoring your heart health. That’s because people with diabetes are at an increased risk of high cholesterol and other heart problems. Luckily, properly managing diabetes and high cholesterol can reduce your risk of heart complications and improve your long-term health.

Abnormal cholesterol levels caused by diabetes is known as diabetic dyslipidemia. In general, the link between diabetes and high cholesterol comes from two factors. First, they share similar lifestyle risk factors. Second, diabetes itself can also negatively affect the heart and blood vessels.

High Cholesterol from Diabetes

If you’re familiar with cholesterol, you’ll know that there are different types. For example, one of the “bad” forms of cholesterol is the low-density-lipoprotein (LDL) cholesterol. When LDL cholesterol is high, you are generally at an increased risk for heart disease.

“Diabetic dyslipidemia … will include other factors beyond [LDL] cholesterol,” says Lawrence Phillips, MD, cardiologist at NYU Langone Health. “What you'll see is an increase in triglycerides, which is the fat in the blood, and a decrease in the HDL, which is the 'good' cholesterol.”

A combination of high triglycerides and high LDL levels is associated with atherosclerosis, according to the American Heart Association. Atherosclerosis is the process of plaque buildup on the artery walls. When this occurs, it increases the risk of heart attack and stroke.

As previously mentioned, high cholesterol and diabetes share some lifestyle risk factors. For example, high blood pressure, physical inactivity, and obesity are risk factors for both diabetes and high cholesterol.

Furthermore, poorly controlled blood sugar levels can damage the blood vessels. Consequently, this may lead to atherosclerosis and increase the risk of heart attack and stroke.

Managing the Risks

“If either high cholesterol or diabetes are poorly managed, we can see end-organ disease,” says Dr. Phillips. “What that means is that we can see problems with multiple body systems.”

High cholesterol that goes untreated can increase the risk of heart attack, stroke, and kidney failure. “In diabetes, if it's poorly controlled, we can see all of those problems but also problems with the eyes [and nerves],” says Dr. Phillips. Learn more about complications of diabetes here.

Lifestyle changes that can improve control of diabetes and high cholesterol include:

  • Managing weight
  • Increasing physical activity
  • Eating a heart-healthy diet
  • Quitting smoking

“Separate from lifestyle modifications, there are medications that will improve or decrease the risk of progression of disease,” says Dr. Phillips. This may include medications to improve blood sugar control, and/or medications to lower cholesterol.

“When you're having difficulty getting control [of diabetes or cholesterol], it's important that you ask for help,” says Dr. Phillips. “By having an honest conversation, you can decrease those problems and really have a significant impact on your long-term health.”