Diabetes Management

Are Cholesterol and Diabetes Interrelated?

May 2022

People with diabetes cannot eat rice, and they should not eat fruits, diabetes and cholesterol and interrelated. There are a few myths about type 2 diabetes that are baseless and not substantiated by research, like the first two statements.

However, the link between cholesterol and diabetes is well established. Both of these are metabolic disorders which are caused by insulin resistance. Let’s understand this connection in detail. 

Increased cholesterol levels and diabetes are the most prevalent lifestyle conditions all across the globe today. There is no doubt that India is racing towards becoming home to the world’s highest diabetic population as statistics indicate the ever-increasing rate of people with high cholesterol levels in the country, specifically in the urban centers.   

This situation leads to an inevitable question: Is there a connection between cholesterol and diabetes? Yes, there is! People with type 2 diabetes are at an increased risk of compromised coronary health. Let’s understand the relationship between the two and how to stay on top of this tricky situation.

Cholesterol and Coronary Health

Cholesterol is a type of lipid or fat-like substance produced by the liver in the human body. It is an essential component for cell formation and fat digestion. Another source of cholesterol in our body is the direct consumption of animal products like dairy, meat, and poultry. There are two types of cholesterol:

  • LDL (low-density lipoprotein) – It contributes toward fatty (plaque) build-ups in the arteries and is, thus, termed ‘bad’ cholesterol.
  • HDL (high-density lipoprotein) – It functions as a carrier for transporting LDL away from the arteries back to the liver where the LDL is broken down to be expelled from the body. This is why HDL is tagged as ‘good’ cholesterol.

Triglycerides are the most common form of fats in the body and are tested along with LDL and HDL when checking the cholesterol levels in the body. High triglyceride levels combined with high LDL and low HDL levels indicate fatty build-up in the arteries, thus, posing an increased risk of heart attacks and strokes. Therefore, it is important to keep a check on your cholesterol levels; every 5 years, starting from the age of 20. The check-ups should be more frequent if one is over the age of 45 and/or is suffering from other risk factors like obesity, family history of heart disease, or diabetes.

How are cholesterol and diabetes interrelated?

According to the American Heart Association, diabetes can cause something called diabetic dyslipidemia. This condition is marked by an elevated level of triglycerides and a reduced HDL level. Moreover, people with type 2 diabetes tend to have a higher amount of smaller and denser LDL particles in their systems than people who do not. This situation allows for the LDL particles to easily invade the blood vessel walls and cause a greater plaque build-up in the arteries, thus, increasing the risk of heart diseases. Even with controlled blood glucose levels, people with diabetes are at an elevated risk of cardiovascular diseases or strokes. Statistics show that up to 70% of people with type 2 diabetes have diabetic dyslipidemia. 

Are there any apparent symptoms?

People with type 2 diabetes may experience some symptoms of diabetic dyslipidemia when the condition becomes severe. These may include:

  • Chest pains
  • Stomach aches
  • Muscle pain
  • Breathing difficulty
  • Confusion

What kind of health management is required to address this situation?

Lifestyle modifications are the first-line intervention in the management of diabetes dyslipidemia. There are three aspects to it – weight loss, diet management, and physical exercise. 

A major part of the management plan comprises a robust diet plan. And, since we have to keep cholesterol as well as diabetes in check, the most important aspect of diet management is to keep a keen eye on the consumption of carbohydrates and saturated fats. Following are some of the additions a type 2 diabetic person can make in their diet:

  • Omega-3-rich food: Fish like herring, salmon, sardines, and mackerel are great sources of omega-3. Vegetarian and vegan sources of omega-3 fats include walnuts, linseeds, chia seeds, and rapeseed or flaxseed oil.
  • Nuts: Increased and regular nut consumption plays a significant role in lowering cholesterol levels as nuts contain unsaturated fats as well as *plant sterols and stanols. Walnuts, almonds, and cashews are some good sources. 
  • Soluble fibers: Soluble fibers like green peas, cluster beans (gavar phali), cabbage, cauliflower, beetroot, sweet potato (shakarkand), guava, apple, papaya, dried fig (anjeer), pulses as well as isabgol (psyllium husk) help in cholesterol regulation. Oats and barley contain a kind of soluble fiber, beta-glucan, that forms a gel and binds cholesterol, thus, preventing it from getting absorbed into the bloodstream. 

*Note: Plant sterols/ stanols are naturally found substances present in fruits and vegetables in small amounts. Research has shown that having 1.5gms–2.4 gms of plant sterols/stanols every day can lower cholesterol levels in two to three weeks. They are also safe to use alongside medications such as statins or fibrates.

Is medical intervention required?

Research suggests that the most optimum solution to prevent cardiovascular disease in this situation is found to be an LDL-lowering medication called ‘statin’. Statin is primarily given to people with type 1 diabetes. For people with type 2 diabetes, those who have a 10% or greater 10-year risk of developing cardiovascular disease need to be given statins. 

What else needs to be done?

  • Be regular with physical exercises. If necessary, take help from a professional trainer to set up a regulated workout routine for yourself. Stick to it with discipline. The American Heart Association recommends 150 minutes of moderate-intensity aerobic activity spread throughout the week.
  • Be regular with your medical check-ups and follow-ups, especially your cholesterol check-ups.
  • Quit smoking. Cigarette smoking is linked to higher cholesterol levels. It also contributes to the formation of a high-risk form of LDL called oxidized LDL, which contributes to plaque build-up in your artery walls.
  • Strictly avoid fried and baked food items as they are loaded with saturated fats and significantly contribute to increased levels of LDL.


Managing diabetes and associated risks such as cholesterol requires a comprehensive approach that combines medical management and lifestyle management. Fitterfly’s programs for weight loss, prediabetes, and type 2 diabetes – Reset23 and Diabefly Pro help you manage your health conditions with doctor-designed, clinically validated programs that work on your diet, exercise, stress, sleep, pain, along with psychological intervention for healthy habits formation to ensure you can sustain your progress. 



  1. https://www.webmd.com/cholesterol-management/high-cholesterol-diabetes#:~:text=If%20you%20have%20type%202,health%20conditions%2C%20including%20high%20cholesterol.
  2. https://www.medicalnewstoday.com/articles/cholesterol-and-diabetes
  3.  https://pubmed.ncbi.nlm.nih.gov/25242435/
  4. https://www.heart.org/en/health-topics/cholesterol/about-cholesterol
  5. https://www.cdc.gov/cholesterol/checked.htm
  6. https://academic.oup.com/jcem/article/86/3/965/2847382
  7.  https://www.myupchar.com/en/disease/diabetic-dyslipidemia
  8. https://www.diabetes.org.uk/guide-to-diabetes/enjoy-food/eating-with-diabetes/managing-other-medical-conditions/cholesterol-and-diabetes

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