[Caravaggio]

I recently completed my annual diabetes-related medical check-up. I just got the results. They are generally good except for my cholesterol numbers.

HbA1c - 4.9

liver, kidney, etc. - normal, nothing to worry about.

BUT my cholesterol levels are all over the place. (I don't have my previous cholesterol results on hand but I know which numbers went up and which ones went down).

Total - 259 (Definitely went up big time.)
HDL - 83 (went up a lot, which is good.)
LDL - 168!!! (Definitely went up big time)
Tri - 85 (not sure if this went up or down, but if so either way the number is not so far from previous number).

Just to complete the picture, my opthalmologist says my eyes are fine, and my doctor said I show no signs of nerve problems, my EKG results were "enviable" and my resting heart rate at the time of the test was 48.

I'm trying to figure out what happened to my cholesterol level. These are the changes in the last 6 months, when the last cholesterol test was last taken. I'm not saying these contributed to my high cholesterol count.

1. Exercise - I started running at a lower heart rate. This initially meant I had to reduce the intensity and speed of my running; but I've started to pick up speed while maintaining low heart rate.

2. Diet -

i) I gave up my Fiber One cereals for breakfast.

ii) I started eating more eggs - meaning 1-3 eggs 4-5 days a week (mostly for breakfast); from mere 1-2 eggs a week. This started maybe 3 months ago.

iii) I've reduced my desserts to 1 night a week, from 2-3 nights a week previously, although my desserts are in very small quantities.

I still eat a lot of fruits and vegetables, as before. I still eat chocolate (independently of dessert) as before. My carb intake probably decreased since I no longer eat cereals for breakfast and have reduced my desserts.

I'm open to suggestions that may explain, lead to an explanation of, or guide my search to the recent huge increase in my cholesterol levels.

[morrisma]

Your A1c is great but with all the heart complications tied to diabetes, your doc isn't going to let that cholesterol stuff go. I put off the drugs for 2 years trying unsuccessfully to drop the numbers by diet alone. Good luck and stay aware!
Mike

[fgummett]

First off... amazing A1c

Your fantastic HDL and pretty darn good Triglycerides (<70 is even better) trumps LDL in my book.

Did you read this yet? Beyond Routine Cholesterol Testing: The Role of LDL Particle Size Assessment... by Paul E. Lemanski, MD, MS, director of the Center for Preventive Medicine and Cardiovascular Health, Prime Care Physicians, P.C., and assistant clinical professor of medicine at Albany Medical College.

LDL is only a [calculated] measure of the volume of LDL particles in a given sample BUT LDL particles are different sizes with the large fluffy kind being considered much less harmful that the small dense kind.

Think of a measuring jug filled with either wild blueberries or grapes... now count the number of wild blueberries and compare with the number of grapes -- same volume, very different number of particles.

So... is it better to have a high volume of relatively harmless large fluffy (300% difference in risk) LDL, or a small volume of small dense LDL?

Total Cholesterol includes HDL ...so if HDL is up so is Total Cholesterol -- so why do folks get upset when Total Cholesterol goes up?

Total Cholesterol includes LDL so why beat yourself up over raised Total Cholesterol AND raised LDL?

From my reading the only reason to consider Total Cholesterol is in the ratio of Total Cholesterol / HDL which is considered good if < 4.0 ... yours is 3.1

You may also find this interesting http://www.youtube.com/watch?v=awA2f...eature=related

[kgm0612]

Congratulations on a fantastic A1c!

Karen

[foxl]

EXCELLENT A1c.

Lipids are frustrating. I caved and am currently on the max dose of Simvastatin.

[Caravaggio]

Thanks for the responses. Normally I'm not worried about my cholesterol count, but the huge jump in LDL did worry me. The huge jump in total cholesterol was also a concern since it is likely due to the rise in LDL count.

I was also worried because my doctor was unusually concerned. He is open to many things, is not prone to panic, and listens to his patients. So when he voiced real concern about my cholesterol count, I had to listen. He threatened to put me on statin unless I can bring the numbers down in 2 months. I was so surprised at this that I didn't even ask how came up with 2 months.

Frank, I'll check the links you mentioned. Thanks. My question in this regard is - do I ask my doctor to test my LDL particle size? Or do I not really worry about this even since my HDL and Triglyceride numbers are fine (though I should probably aim for lower triglyceride numbers)?

After thinking about this last night, I decided to keep doing what I'm doing while I read about cholesterol. To date, I've been reading about diabetes but not about cholesterol, although this topic has been touched upon countless times in DF.

[fgummett]

There is a blood test for particle size: Apo-B if memory serves. Not yet in wide use but t can help to calm your Doctor's fears.

I look at it this way:
the risks of high BG are known and well documented... we have clearly defined management techniques to help keep our BGs in a better range.
Cholesterol risks and management techniques are still highly debate-able (despite what the drug companies are telling us) and the treatment questionable, if not downright risky itself.

Here's a clip from the Fat Head movie about the Lipid Hypothesis : YouTube - Big Fat Lies

[dbaratta]

Jealous of your A1C, congrats!

[fgummett]

Sorry to keep on at this but I meant to say...

my EKG results were "enviable" and my resting heart rate at the time of the test was 48

...you're an athlete! are you seriously gonna believe that you are at increased risk of cardio vascular disease (CVD)..?!? Heck I'd like to see some plaque jut try to build up in your arteries with the flow of blood you must be pushing through there

OK I'm done... for now