By Adam Garcia
In Diabetic Dictionary this week we will be talking about LDL and how it affects a diabetic. LDL refers to low-density lipoproteins, a type of molecular protein produced in the liver that carries cholesterol through the blood. It also may refer to the LDL test. Specifically we will be talking about LDL cholesterol, but we will also touch base on the lab test.
Though low-density lipoprotein is frequently called “bad” cholesterol, it does have some positive features. It carries amino acids and antioxidants to other cells. However, too much LDL can lead to a number of significant health problems, so the negative impacts far outweigh the positive aspects of this protein.
In general, when one hears the term cholesterol, it refers to low-density lipoproteins. This is because LDL cholesterol provides a steady stream of cholesterol to the arteries. When advertisements claim a product can reduce your cholesterol, they are referring to the risks of high LDL levels.
Those with high levels of LDL cholesterol are at great risk for hardening of the arteries or artery blockage, which can enlarge the heart or completely cut off blood supply to the heart. This, in turn, can lead to heart attacks, or necessitate surgery to remove blockages. Other main arteries in the body can also become blocked, a condition known as peripheral artery disease, and require clearing via catheterization to restore normal blood flow to and from the heart. High cholesterol also increases the risk of sudden stroke. Clogged arteries can lead to excess clotting of the blood. These clots can then pass to the brain or lungs, causing thrombosis. The presence of low-density lipoproteins can also decrease the level of high-density lipoproteins, known as the “good” cholesterol.
Given the very dangerous medical conditions associated with high levels of LDL, it makes sense to keep one’s levels of this protein at a very low rate. Testing for LDL cholesterol is quite effortless, usually requiring a simple blood test to measure all cholesterol levels in the body. A physician may require that you fast for 12 hours prior to testing, but usually the test itself only takes a few minutes. Below is a sample Lipid Profile. As you can see, the LDL level for this patient is optimal.
The American Diabetes Association (ADA) recommends that all adult patients with diabetes have their lipid profile determined yearly. They also recommend an LDL cholesterol level of <100 mg/dl (less than 100 milligrams per deciliter), which is considered best. The American Heart Association (AHA) has adopted the same standard.
Reducing LDL cholesterol levels can be simple for some. Following a diet with lower saturated fat and higher fiber, plus exercising, can sometimes be enough to lower cholesterol to accepted levels. Others, however, may need to combine diet and exercise with cholesterol-reducing drugs.
Some common mistakes that people make about cholesterol are:
- The belief that cholesterol can be lowered by medication alone. In general, this is not true, and in any case, those with high LDL cholesterol levels are at greater risk for heart disease, so adhering to a sensible diet and exercise regimen makes sense in any case.
- Assuming that body size indicates cholesterol level. While it is true that overweight people tend to have higher levels of LDL cholesterol, it does not follow that thin people cannot have high levels. In some cases, high levels of bad cholesterol are genetically predetermined. Family history of high cholesterol is reason for greater vigilance in anyone.
- Men have higher cholesterol than women. Though high cholesterol levels arise more frequently in men, women still need to have their levels checked. While pre-menopausal women tend to have lower levels because estrogen blocks some cholesterol production, post-menopausal women do not have this safeguard.
A high LDL level is a matter of concern, but fortunately it can often be medically addressed. Working closely with your healthcare team to create a better diet and a good exercise program, and to determine whether cholesterol-reducing drugs should be applied, is an excellent way to prevent the health conditions associated with LDL “bad” cholesterol.
Next week on Diabetic Dictionary we will be discussing the “good’ cholesterol, HDL. If you have a term for diabetic dictionary that you don’t understand just email us or leave a comment or question below.
