Speaker: Monitoring cholesterol.

Dr. Lee: The insulin resistance is associated with abnormalities in your cholesterol levels, not only in the quality but also the quantity of cholesterol that you have in your blood stream and it is thought that this particular aspect of the condition is what accelerates the Arteriosclerosis that may occur in people with diabetes.

Speaker: Cardiovascular disease is very common but as you have already heard, it’s of particular concern if you have diabetes. It is therefore critical to actively manage all coronary risk factors including elevated cholesterol. Please ensure that your cholesterol level was checked at the time of diagnosis. It should be checked again every 1 to 3 years depending on your circumstance.

Dr. Lee: The cholesterol in the blood initially goes through a process called oxidation and it is then eaten up actually by white blood vessels called monocytes in your blood streams. These then go into the walls of your arteries where they essentially die off and these little chronicles of cholesterol tend to coalesce and form foam cells and eventually, if you have enough foam cells, they form a plaque which is the deposition of cholesterol within the wall of your artery. When you have enough plaques we calls this arteriosclerosis.

Speaker: You may know that LDL is often referred to as bad cholesterol and HDL if often referred to as good cholesterol, but it’s important to understand what your ideal targets should be because you have diabetes your LDL should be less than 2 MMOL/L and your total cholesterol to HDL ratio should be less than 4.

Dr. Lee: The number right now that we tend to look at usually relates to the level of bad cholesterol, but you should also know your ratio which is the total cholesterol divided by your good cholesterol level and both of these are very important in guiding your treatment for your cholesterol levels.

Speaker: If your cholesterol is elevated a healthy lifestyle including proper nutrition and regular exercise is very important. Do your best to achieve your ideal body weight. If you are obese, even a modest weight loss is a benefit; if you are unable to reach your targets with lifestyle changes alone, medication is available.

Dr. Lee: You should always know what your cholesterol level is. If you don't ask your doctor and check to make sure that it is within the safe level for you, if not perhaps you need medication to bring it to that level, perhaps you need a change of medication or additional medications; your doctor will monitor the levels at periodic intervals, write them down somewhere so that you are always familiar with what your levels are.