LDL level for diabetics

[lgvincent]

I saw on the news tonight that it is suggested that the LDL level for persons at high risk of having heart disease (including diabetics) should have an LDL level of 70 or below. I'm curious to know how many are in that range. With my last lipid profile, my LDL was 116. I was kind of happy that it was getting close to the 100 level again but looks like that isn't good enough.

[Lorna]

I've never even had that measured! Is it like colesterol?

[lgvincent]

Yes, I'm sure if you look at the results of your most recent lipid profile, you'll find the measurement for it easily. Among other things, it will give you a reading for total cholesterol, HDL (what is often called "good" cholesterol), LDL (often called "bad" cholesterol), and triglycerides.

Of course, I'm under the impression that labs outside the United States use international units, rather than milligrams per deciliter so in order to get the measurement in International Units, you would need to multiply the mg/dL by 0.0259. I didn't bring a pen with me so it will take me a while to convert the 70 mg/dL to IU in order to know what goal you should be working for.

[lgvincent]

HDL is high-density lipoproteins, the LDL is low-density lipoproteins, and VLDL is very-low-density-lipoproteins, but I can't recall if I see a measurement for that on the lipid profile or not. I'm sure there is one but I just can't recall seeing it.

[hermitladee]

They keep lowering the ldl threshold, but they haven't lowered the heart disease incidence. Extremely high cho, yeah, worry about it. But ldl levels around 100 with an hdl above 35... I don't see the benefit, from what studies I've seen, that lowering it will make people healthier.
There are people with ldl levels higher than 100 that don't get CHD, and there are people with levels lower than 100 than do get CHD. So, where's the advantage in lowering it??

[lgvincent]

Sadly, that does seem to be true. There are a number of factors which seem to influence if we have heart disease or not but since I've got two that seem to increase risk (family history and diabetes), I can't help but feel that there is a good chance that a heart attack lies in my future, so I must do what I can to help prevent it.

[hermitladee]

Is it that all diabetics are prone to heart disease or just those who don't have good control over their bs levels? I've read where if a diabetic keeps their bs level in control, has an a1c at 6 or below and doesn't inject large doses of insulin (which can lead to clogged arteries) to compensate for eating a poor diet, their chances of heart disease are the same as nondiabetics.

I think that weight, cho, bs levels, blood pressure levels all contribute, like you said. But if bs levels are good, then the diabetes factor shouldn't come into play.

I'd keep a close watch on your blood pressure as that seems to be a higher indicator of heart problems.

Good luck on your road health! :D

[lgvincent]

Insulin clogs arteries?!? I've never heard that before. I've been taking it since 1968 and several years ago had an angiogram that I was told looked clear. Now I've got to worry about that too.

[KLD]

Hermitladee said that insulin clogs arteries if it's taken in large doses to compensate for eating a poor diet. I've read that, too, and it's what worries me about people on this forum who say that they eat what they please and then cover it with extra insulin. If you eat sensibly and only use enough insulin to cover what you eat, then I don't think you have anything to worry about. That's exactly what happens naturally with non diabetics who eat a sensible diet.

Karen

[HeatherP]

Nobody is saying "eat a crappy diet and you'll be fine as long as you inject enough insulin". It's just that some of us prefer a bigger variety of foods and we don't restrict ourselves to only certain things. If I have the freedom to eat just about anything I like, and I do, then I'm going to indulge myself from time to time. I eat a well-balanced diet most of the time, with a little excess every now and again.

Insulin does not clog arteries.

[Lorna]

With reference to eating "what you please" this can also mean eating little and injecting little insulin. As far as I am aware the healthy eating gulidelines for diabetics are the same as for anyone else, it is just we need to montior ourselves more closely.

Is there not also a problem with diabetics tending to put on weight around the stomoach rather than the hips?

[KLD]

I have no idea whether insulin clogs the arteries or not, Heather. I was simply clarifying what Hermitladee said in her post to reassure Lowell that she wasn't suggesting everyone taking insulin would get clogged arteries. As I say, I have read that excess insulin clogs the arteries, but I'm no expert about insulin, and don't know whether that's true or not. It's certainly true that high levels of insulin circulating in the bloodstream can cause heart damage - that's one reason diabetics are prone to heart attacks - but exactly how that comes about I don't know.

Karen

[hermitladee]

Before anyone gets their panties in a bind, let me go back to my origninal post...

I was referring to large doses of insulin. That means excessive. Not everyone who injects insulin is putting themselves at risk. Usually if you would be injecting too much insulin, your triglyceride level would increase. So, if your level is fine, you need not worry.

But hyperinsulinemia has been associated with increased risk of atherosclerotic cardiovascular disease in some studies.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7616851&dopt=Abstract

"Participants with hyperinsulinemia in all four race-sex groups had more atherogenic levels of most risk factors studied than those with normoinsulinemia."

http://www.findarticles.com/p/articles/mi_m0CUH/is_8_24/ai_78130346

"Insulin resistance may be an expression of diffuse arterial endothelial dysfunction contributing to atherosclerosis [3], may lead directly to arterial damage through toxic effects of hyperinsulinemia [4], or may act indirectly through atherogenic effects of the constellation of risk factors associated with the insulin resistance syndrome (IRS) [5,6]. Insulin resistance or hyperinsulinemia has been associated with CVD in some but not all studies, suggesting that previously unmeasured factors may be involved in the link between hyperinsulinemia and atherosclerosis [7-12]. "

[HeatherP]

It wasn't my intention to offend anyone, and if I have then you have my apologies.

Seems to me if you're injecting "too much" insulin, then you've got a more immediate problem of hypoglycemia. Then there's weight gain due to "feeding your insulin" which means having to eat more than you might need to just to avoid lows, which is going to contribute to bad health.

I'm sure we can all agree on one thing:Bad blood sugar control equals bad health overall, no matter if you're experiencing lots of highs or lows.

Anyway, didn't mean to step on toes, and my unmentionables are not in a bunch:D .

[Belinda]

Whew glad you cleared that up! Not sure what myLDL level is...just went to the Dr. this morning. If he doesn't check it then I will go look at the last time he did. Mine was ok I think...**** I am going to have to go and look now!!!!

[Belinda]

Ok my LDL was 93 (bad cholesterol) and HDL was 48 (good cholesterol) now what all this means in reference to my heart.... well he hasn't told me to do anything different yet. These numbers are from a year ago they are due again so maybe they did it today!

[KLD]

Originally posted by HeatherP
... my unmentionables are not in a bunch:D .
Neither are mine, Heather!!!

Karen

[HeatherP]

As of April:

LDL: 79
HDL: 92
Tryglycerides: 82
Total cholesterol 187

[KLD]

Mine are good too, unless we accept the number Lowell's article suggests for LDL. As of January, they were:

Total cholesterol: 4.5 (174 in the US)
LDL: 2.5 (97);
HDL: 1.6 (62)
triglycerides 0.8 (71)

[Lorna]

My last total colesterol was 3.2, not sure what the breakdown was though. With reference to the thing about too much insulin, is it not connected to the fact eating to cover hypos causes obesity which strains the heart?

[hermitladee]

Looks like everyone that posted is doing great! Those cho numbers are good. It's good to see people taking care of themselves. :) I'd made the mention of excess insulin earlier since a woman I know who is type 2 and is still producing some insulin (although ineffective due to IR) will eat anything and compensate with a shot. She is overweight and will eat a large amount of doughnuts, pizza, drink regular sodas, and never give it a second thought. This might not be a problem for type 1s or 2s who are not making insulin and who are not IR, but for IR type 2's it can be a problem. She has been on my mind lately, and I'm worried about her.

But, I guess we ought to get back to lgvincent's original question about lowering ldl down to 70...

Does anyone else think that it will prove to be a benefit in lowering the incidence of heart disease?

[Lorna]

I think it's probably like everything else- it will be worth it, just hard work!

[Oradev]

My last LDL was 105. My doctor told me that he wants me to get on Lipitor because it was not < 100. My total cholesterol was 169, which I thought was pretty good, but I guess not. And since heart disease runs in my family, I should listen to him.

[hermitladee]

It seems from what I've read, the risk benefit ratio of lowering ldl is favorable for those under 50. Negligible for those 50-65. And for those over 65 low ldl is associated with higher mortality. For example in this study... http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8481074&dopt=Abstract

So, it seems it's impossible to say a lower ldl is beneficial to everyone. But it could be a good idea for some.

[Belinda]

The latest numbers are
total cholesterol 147
triglycerides 60
HDL 47
LDL 88

My sheet the doc sent has these numbers for goals

Triglycerides <250 fasting
HDL (good) >45 for men and >55 for women
LDL (Bad) <130 routine and <100 diabetes


Ok how do you raise your good cholesterol? with out messing up the rest?????

[Harold]

The only thing I found that raises my HDLs is an increase physical activity.

[Belinda]

OH NO! not more exercise....there has to be a pill!!!!!

[Deager]

Jack's numbers in June:

Cholesterol 125
Trig. 57
HDL 72
LDL 42

A1C June 6.1

Also, Jack had four heart tests last week, including the two where they inject you with radioactive isotopes and the doc said his heart is super great. No clogged arteries. I mention this because for many years his BG's were normally 300+ and he took big doses of insulin. He also smoked and drank a lot of beer. Keep in mind, he has been a diabetic for 38 years. So heart disease and BG control and insulin dosages aren't always related. I think genetics has a huge amount to do with it.

Of course, he no longer smokes (20 years off the habit now), only has maybe 4 beers a week (Michalob Ultra Light....2.5 carbs), eats low carb (approx. 30-40 per day) and is on the pump, all of which has made a huge difference.

Diane