My LDL is high (111 mg/dl). How can I decrease it, when everything else is great?

In an effort to prevent cardiovascular disease in diabetes, the goal for LDL (low density lipoprotein) management in the presence of diabetes is less than 100 mg/dl. LDL cholesterol is the component that builds plaques (blockages) in the coronary arteries, which can lead to the development of heart disease. We know that if we can reduce the LDL cholesterol number to less than 100 mg/dl through either dietary therapy, medical therapy or both, we can prevent a high percentage of the people who develop heart disease from ever doing so. This newly revised LDL goal is for both people with known coronary artery disease and for persons with diabetes with or without known heart disease.

The LDL cholesterol component is directly affected by dietary intake of cholesterol, saturated and/or hydrogenated fats. Consultation with a dietitian can help you to identify sources of saturated fats and cholesterol in your diet, and provide you with ideas for replacing those with healthier alternatives. Oatmeal has also been shown to have a beneficial effect on LDL levels. So too may increasing the amount of fruits, vegetables, olive oil, omega-3 fatty acids from fish, soy proteins, and soluble fiber in your diet.

Some physicians will treat patients with diabetes with medications from a class called “statins”. There is evidence that statin drugs (such as Lipitor, Pravachol, Lescol, Mevacor, and Zocor) lower LDL cholesterol by 30-50%, and may have other beneficial/protective effects.

Discuss these options with your healthcare team. Congratulations for taking an active role in disease prevention!

DMW