Sugar Matters
July 24, 2009
Back to Cholesterol: what’s the goal and WHY is it the goal?

There is no doubt that by now you have realized there are many goals that your doctor is using in regard to your diabetes control. The goals are your targets, and sometimes are simply “positive or negative” but at others times have an actual number or value attached. For those with diabetes, the number/goal you probably hear most often is the Hemoglobin A1C of 7% or less.{{more}} This should be drilled into your heads by now! Cholesterol has similar targets. Different laboratories may have slightly different measures and value ranges, but on the whole Total Cholesterol should be less than 200mg/dL; HDL (the good cholesterol) should be over 40mg/dL; Triglycerides should be less than 150mg/dL; and LDL (the “Bad” cholesterol) should be less than 100mg/dL.

For the past several years, LDL cholesterol has been the major player in regard to targets for cholesterol, although really the entire profile is important. Why is LDL so important? Much of the research that has been done thus far showed us that higher levels of LDL are associated with bad events, like development of heart disease, strokes, peripheral vascular disease etc. The higher your LDL, the greater your chances of one or more of these diseases striking you at some time in the future.

On the flip side, we also have good research showing us that if you can decrease LDL, your chances of those same diseases will also decrease. This is golden information! The best part about this is that we have ways to decrease your LDL, through diet changes, glucose control and medications. The trick is that you need to use those methods in order to get results. Sitting and hoping your LDL will get better on its own will not work—you need to put in some work to make this happen.

Your goal as someone with diabetes is to have an LDL less than 100mg/dL, and as close to 70mg/dL as possible. A few years ago 100mg/dL was the goal, but then a few very impressive research studies showed that people with diabetes are at very high risk for having cardiovascular disease. However, this risk improves if you lower the LDL closer to 70mg/dL. So the short story is this: high LDL is a major risk for future vascular disease of all types, LDL less than 100mg/dL is good, but LDL less than 70mg/dL is even better.

High cholesterol is like high blood sugars-most people don’t pay much attention to it because you can’t feel it. You often don’t feel badly with a high cholesterol. It doesn’t really hurt, and when it improves you don’t feel any different. BUT PAY ATTENTION. Just like those high blood sugars, high cholesterol does its own damage without your feeling anything, at first. It clogs small and large blood vessels all over your body, and paves the way for something ugly in future. It may be a stroke. It may be a heart attack. It may be a cold foot that ends up being cut off. Would any of you voluntarily sign up for this? I didn’t think so…

Ask your doctor about your cholesterol. Find out if it is improving or not, and ask what you can do to get to your goals.

Until next week, stay safe and healthy, Vincies!

Anita Ramsetty, MD
Medical Director Endocrine Care Group

Tel: 843-798-4227