Diabetes and Hyperlipidemia – How Are They Related?

If you have type 2 diabetes, you’ve likely heard that there are risks with the disease if it is not managed well. Some of the most common complications of poorly managed type 2 diabetes include nerve, eye, kidney damage, and heart disease. According to the CDC, heart disease is the leading cause of death in the U.S.(1). The risk of heart disease is higher with type 2 diabetes because diabetes increases blood lipid levels (hyperlipidemia). So what exactly is hyperlipidemia, and why does your risk increase when you have type 2 diabetes? Let’s dive into that!

What is hyperlipidemia?

Hyperlipidemia is the buildup of fats in the blood, mainly cholesterol and triglycerides (2). We will explain each of these in more detail below:

Cholesterol

There are two types of cholesterol that roam throughout the bloodstream – HDL, or “good” cholesterol, and LDL, or “bad” cholesterol (2). We need a balance of both types to lower the risk of developing hyperlipidemia (2). LDL, or “bad” cholesterol, moves cholesterol into the arteries where it can build up and form plaques that reduce blood flow. HDL, or “good” cholesterol, moves cholesterol out of the arteries and into the liver to be stored or removed from the body. When plaques begin to form in the arteries, the chances for heart attack or stroke go up due to a higher risk for blood clots caused by the plaques (2). Our HDL and LDL cholesterol levels are influenced by our diets, which we will explain in detail below (2).

Triglycerides

Triglyceride levels are also influenced by our diets (3). Triglycerides are the main form of fat stored in the body (3). They flow through the blood as a form of energy after periods of not eating and after eating meals high in fat (3). Triglyceride levels increase with lack of exercise, being overweight or obese, smoking cigarettes, drinking alcohol, or having insulin resistance (type 2 diabetes) (3). 

How does diabetes contribute to hyperlipidemia?

In type 2 diabetes, insulin resistance makes blood sugar levels rise as glucose cannot get into the cells to be used for energy. Insulin is not only responsible for helping glucose get into the cells, it also helps fat get into fat cells for storage (4). Without the ability for the fat and sugar to enter the cells, it builds up in the blood leading to hyperlipidemia (high blood lipids) and hyperglycemia (high blood sugar). 

Treatment options

How can you reduce your risk of developing hyperlipidemia with type 2 diabetes? The best treatment methods include weight loss if you are overweight, increasing your physical activity, eating fewer saturated fats and cholesterol, eating more fiber and an overall healthier diet, and taking lipid-lowering drugs if necessary (5). (Stay tuned for a future blog post on a supplement you can take to help lower blood sugar levels and blood lipid levels!) 

Where to Start

Exercise

All of the prevention/treatment ideas can sound daunting. We recommend making one small change at a time. Increasing physical activity from 0 days to 1-2 days a week is a great start! Do your best to build up to 30 minutes of moderate exercise per day to start seeing benefits (5). Are you wondering which exercise is best to lower hyperlipidemia? The type of exercise that you enjoy and/or the type of exercise that you’ll do! Some fun exercise options include pickleball, rollerblading, swimming, cycling, walking, hiking, aerobics classes with friends, high fitness, or training for a race.

Diet

The most important diet changes you can make to lower your blood lipid levels are these:

• Bring saturated fat intake down to 5-7% of your total calories (5)
• Eat less cholesterol (fewer eggs and less meat)
• Replace some meat with plant-based proteins
• Eat at least 5 servings of fruits and vegetables per day
• Eat at least 25 grams of fiber per day if you are female and at least 30 grams a day if you are male
  
• Limit sweets to less than 7-10% of your total calories

Conclusion

If you have diabetes, you are at an increased risk of developing hyperlipidemia. If you already have high cholesterol levels, please reach out to one of our registered dietitians. They will help you find sustainable changes that will fit your lifestyle. They also provide accountability for you to stick to your goals and keep you motivated.