| Your A1c was great but you need to get your triglyceride level down.
Triglycerides are bundles of fats found in the blood stream especially after we eat. The body manufactures triglycerides from the carbohydrates and fatty foods that we eat. Almost 90 percent of the fat content of most non-lean meats is triglyceride.
What is a normal triglyceride level, and what should be my goal?
Triglyceride concentrations are currently rated as follows:
Desirable/normal: Less than 150 mg/dl
Borderline high: 150-199 mg/dl
High: 200-499 mg/dl
Very high: 500 mg/dl or greater
In the normal fasting state, the triglyceride level is around 100 to 150 mg/dl or less, but it will rise to 300 mg/dl or more just after a meal. In patients with type 2 diabetes, triglycerides are frequently elevated both in the fasting state and even more so after eating. It is important to be fasting overnight (preferably for 12 hours) when your blood is drawn for a lipid panel that includes triglyceride testing. You should also abstain from all alcoholic beverages for 24 hours before this test.
Just as with LDL cholesterol, the lower the triglyceride level the better. Most clinicians prefer that patients with type 2 diabetes keep their triglyceride level at or below 150 mg/dl to minimize their cardiovascular risk. It is not unusual for some people with type 2 diabetes to have triglycerides over 400 or even over 2,000. Very high triglycerides (over 1,000) can be associated with memory loss, skin lesions (xanthomas), abdominal pain and even life-threatening pancreatitis.
How do physicians treat patients with high triglyceride levels?
Triglycerides respond to both diet and medications. It is very important to know that since uncontrolled diabetes causes an elevation of triglycerides, any behavior modification or drug (and especially insulin) that improves blood glucose control will lower triglycerides. Dietary modifications to lower triglycerides are listed below. Statins and other drugs that lower cholesterol such as Lipitor, Zocor, Pravachol, Crestor Zetia and Vytorin have only minimal effects on triglycerides. Several drugs do an excellent job of lowering triglycerides (see below). Many people with type 2 diabetes will require two or even three different drugs to bring their LDL and triglycerides to target and raise their HDL cholesterol. However, most specialists believe that lowering the LDL to target is the most important goal. Lowering triglycerides and raising HDL are secondary goals to be addressed after the LDL goal is achieved.  | 
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