What does low total cholesterol (about 140), normal HDL/LDL, low triglycerides, but high (over 270 mg/dl [15.0 mmol/l]) fasting blood glucose levels with a high glycocylated hemoglobin 11+ indicate? In short, what does it mean if you have high blood sugars with lower to normal lipids? Does injected insulin affect lipid levels?

It is type 2 diabetes that is most commonly associated with dyslipidemia. Type 1 diabetes does not necessarily have a dyslipidemia associated with it, unless there is marked hyperglycemia. In patients with type 1 diabetes, giving superphysiologic insulin doses has been shown to increase HDL-C and lower triglycerides to supernormal levels. Lipoprotein lipase is an insulin-sensitive enzyme and can normalize triglyceride metabolism. Note that triglyceride levels and HDL-C levels are usually inversely related. When you have high triglyceride levels, you usually have low HDL-C levels. LDL-C levels are usually normal in type 1 diabetes. The elevated glycosylated hemoglobin level is bothersome, despite the normal lipids.

JTL