Diabetes & Lipids

Lipids problems are common in patients with diabetes. It contributes to increase the risk of atherosclerosis in the big arteries in your body and may cause heart disease, stroke, or peripheral arteries problems. So, if you are living with diabetes, it is important that you understand your risk of developing heart disease or stroke.

What are the types of lipids in my body that I can measure in my blood test

It Include:

• Total cholesterol.
• LDL (low density lipoproteins): the bad lipids
• HDL (high density lipoproteins): the good lipids
• TG (Triglyceride)
  • High triglyceride might contributes to heart disease
  • Very high triglyceride (more than 10 mmol) may cause inflammation to the pancreas (pancreatitis)

What are the risk factors for heart disease or stroke

The risk factors are :

• Having diabetes for long period (more than 15 years).
• Smoking
• High blood pressure
• High cholesterol (see types of lipids section)
• Having family history of heart attack or stroke at young age (males younger than 55 years of age, or females younger than 65 years of age)

Is every patient living with diabetes at more risk of heart disease or stroke than other people without diabetes

The answer is YES. The majority of patients with diabetes is considered at hi high risk for vascular events and should be treated to prevent heart disease or stroke.

Is every one with diabetes at high risk of heart disease

The answer is NO:

• Younger patients with a shorter duration of diabetes
• Without other risk factors for vascular disease such as:
  • Abdominal obesity
  • High blood pressure
  • Lipids problem
  • Cigarette smoking)
• Having family history of heart attack or stroke at young age (males younger than 55 years of age, or females younger than 65 years of age)

However, it is important to consider that the average patient with newly diagnosed type 2 diabetes may have had the disease before diagnosis.

How do I know if I have any atherosclerosis in my body

You should discuss urgently with your doctor any symptoms suggest atherosclerosis in your body such as

• Chest pain, difficulty in breathing, or jaw pain at rest or exertion (walking or calming stairs) may suggest heart disease.
• Significant dizziness.
• Pain in your calf muscle with walking that relief with rest may suggest peripheral artery problems.

Your doctor can order special tests to know if you have any atherosclerosis if he/or she think that your symptoms are significant …

How can I prevent heart disease or stroke

• Checking your lipids regularly.
• Better glucose control (average blood glucose test (HbA1C) of 7% or lower)
• Better management of blood pressure (lower than 130/80 mmHg)
• Follow a healthy lifestyle:
  • Refrain from smoking
  • Healthy diet (refer to dietitian section)
  • Regular physical activity (30 to 60 min) 5 to 7 days a week.

Your doctor should evaluate you before starting any physical activities, because you may have undiagnosed heart disease.

• Better management of cholesterol (LDL of 2.0 mmol/L or lower, TC/HDL ratio lower than 4.0). This can achieved mainly by lipids lowering medications called statins (such as Lipitor, Zocor, and crestor)