The Importance of Cholesterol for Diabetics

As a diabetic you must have your cholesterol levels monitored to assess your risk of Atherosclerosis and Cardio Vascular Disease (CVD). Diabetics are at a much higher risk to these diseases than non-diabetics so aggressive limits are usually set in terms of cholesterol levels. The standard cholesterol test (also known as a Standard Lipid Panel), is what your doctor normally prescribes to assess this.

The Standard Cholesterol Test

This test will measure you HDL-C (commonly known as your good cholesterol), LDL-C (commonly known as your bad cholesterol), Triglycerides (fat that was digested) and also your Total Cholesterol which is the sum of these components.

Below is a table of target ranges for diabetics from the medical authorities in the UK.

 mmol/lmg/dL
Total cholesterol< 4154.4
LDL-C< 277.2
HDL-C> 1.246.3
Triglycerides< 1.7150.5

Why the Standard Cholesterol Test is Inaccurate..!

If you have read my article, Understanding Cholesterol, you will know that the Standard Lipid Panel is not a very accurate tool to assess your risk profile.

To summarise the article
You have special particles floating around in your blood (comprised of several thousand cells), that consist of a shell filled with cholesterol and triglycerides. The task of these special particles it is to transport the cholesterol and triglycerides around the body.

You can imagine these special particles as ships, the hull is the shell and the cholesterol and triglycerides the cargo. But not all the special particles or ships are the same size, some ships are small and carry a small cargo and some are very large and carry a very large cargo.

The standard lipid panel calculates your LDL using the total amount of cargo ( Cholesterol and Tryglicerides) being transported in your blood.

It is well documented and agreed upon by the scientific and medical community that it is the number of ships that determines the risk factor and not the amount of cargo. It is the ships or particles that cause the damage that leads to Atherosclerosis and Cardio Vascular Disease (CVD).

So if you have few ships but they are very large ships with a very large cargo the LDL-C result will still show as high because it measures the overall cargo. LDL-C does not reflect your risk as in this case your risk is low.

The test that needs to be done should measure your LDL-P which is a count of your ships (or these special particles). This is the true assessment of your risk profile. As stated before the Standard test is for LDL-C.

So why do doctors not prescribe the correct test? Well cost for one, its expensive! And also, many doctors believe that the LDL-C and LDL-P are concordant. That means if one is high the other will be high and if one is low the other will be low. This can be true, but often diabetics are shown to be discordant i.e. not concordant. So that means if your LDL-C is low and you think everything is good, your LDL-P could be high which puts you at high risk but nothing gets done. And the opposite is also true, if your LDL-C is high, your LDL-P may be low and you are at low risk, however your doctor believes you to be at high risk and a statin is most likely prescribed.

The Nuclear Magnetic Resonance Cholesterol Test

The NMR (Nuclear Magnetic Resonance) Lipoprofile is a cholesterol test which provides more information than a standard Lipid Panel.  This test includes measurements for Total Cholesterol, LDL-C, HDL-C, Triglycerides, Insulin Markers, LDL-P and also LDL particle size and more.

This test will give a true reflection of your Cholesterol risk profile. Ask your doctor if you can get have a referral for this test. I expect they will initially dismiss your request but you should persist. However it may not be available on the public health service and so you may have to pay for it privately

The units on the internet are different..!

Different countries give diabetes related measurements in different units. If you read an article that gives you a diabetes measurement that seems different to what you would expect then it may be stated in a different unit. So find out the units used in the article and the also units you use.

Use our Cholesterol Unit Converters to convert values between the two most popular units for Blood glucose measurement – mmol/L used in the UK and mg/dL in the USA. The one on the left can be used to convert your HDL-C or LDL-c and on the right your Triglycerides.  We also provide a quick reference table below.

HDL-C/LDL-C
Triglycerides

All calculated results above are rounded. Therefore doing the reverse calculation using another result may give a slightly different result

HDL/LDL
mmol/L
HDL/LDL
mg/dL
138.6
1.557.9
277.2
2.596.5
3115.8
3.5135.1
4154.4
4.5173.7
5193
5.5212.3
6231.6
6.5250.9
7270.2
7.5289.5
8308.8
8.5328.1
9347.4
Triglycerides
mmol/L
Triglycerides
mg/dL
188.5
1.2106.2
1.3115.1
1.5132.8
1.6141.6
1.7150.5
1.8159.3
2177
2.2194.7
2.5221.3
3265.5
3.5309.8
4354
4.5398.3
5442.5
5.5486.8
5.7504.5