diabetestalk.net

Can Hyperlipidemia Be Caused By Diabetes?

Everything You Need To Know About Hyperlipidemia

Everything You Need To Know About Hyperlipidemia

Hyperlipidemia, or high cholesterol, refers to high levels of fat proteins in the blood. The condition can affect one fat protein or several. Most people will have no symptoms, but having hyperlipidemia increases the risk of developing heart disease. It affects 1 in 3 Americans. Genetic predisposition, cigarette smoking, obesity, poor diet, and an inactive lifestyle can all lead to hyperlipidemia. There are two types of cholesterol, low-density lipoproteins (LDL) and high-density lipoproteins (HDL). LDL is considered unhealthy, while HDL is "good" cholesterol. Cholesterol and lipoproteins are not the same, although they work together. Lipoproteins carry cholesterol to the cells. Usually, there are no symptoms with hyperlipidemia, but it can be detected by a simple blood test. Here are some key points about hyperlipidemia. More detail is in the main article. Hyperlipidemia is a major risk factor for heart disease, the leading cause of death in the U.S. Low-density lipoprotein (LDL) is known as bad cholesterol, while high-density lipoprotein (HDL) is considered good. Regular physical activity can raise levels of HDL and lower LDL. What is hyperlipidemia? Hyperlipidemia means there is too much cholesterol in the blood. Cholesterol is a waxy fat protein made by the liver. It is essential for healthy cell membranes, brain functioning, hormone production, and vitamin storage. Cholesterol becomes a problem when too much bad cholesterol, or low-density lipoprotein (LDL), is produced or ingested through unhealthy foods. Lipoproteins transport cholesterol through the blood to the cells. HDL is good because it carries extra cholesterol back to the liver where it can be eliminated. LDL is bad because it enables excess cholesterol to build up in the blood. Triglycerides are a type o Continue reading >>

Diabetic Hyperlipidemia: High Cholesterol When You Have Diabetes

Diabetic Hyperlipidemia: High Cholesterol When You Have Diabetes

Diabetic hyperlipidemia sounds a bit intimidating, doesn’t it? As we always do here on EndocrineWeb, we’re going to break down that concept for you, and that’s why we’ve put together this Patients’ Guide to Treating High Cholesterol and Diabetes. Diabetic hyperlipidemia is, in fact, having high cholesterol when you have diabetes. The parts of the word hyperlipidemia break into: hyper: high lipid: scientific term referring to fat, cholesterol, and fat-like substances in the body emia: in the blood So all together, hyperlipidemia means that you have too many lipids, especially cholesterol, in your blood. High cholesterol is dangerous for anyone, but as someone with type 2 diabetes, it’s particularly important that you get treatment for high cholesterol. You’re probably aware that diabetes can come with a host of complications—if you don’t take good care of our blood glucose levels and overall health. Cardiovascular complications are common in people with type 2 diabetes, and high cholesterol can also harm your cardiovascular health. Taking care of your high cholesterol will help lower your cardiovascular risk, so in this Patients’ Guide to Treating High Cholesterol and Diabetes, we’ll be covering: cholesterol basics: What is it? What should your numbers be? How often should you be tested? cardiovascular risk in diabetes: Why are you at an increased risk? How does diabetes affect your cardiovascular health? high cholesterol risk factors: Should you be concerned about getting high cholesterol? high cholesterol treatments when you have diabetes: There are medications you can take to help bring down your cholesterol numbers. Also, lifestyle changes are important. eating well to manage cholesterol and diabetes: This lifestyle change is so important that i Continue reading >>

Diabetic Dyslipidemia: Causes And Consequences

Diabetic Dyslipidemia: Causes And Consequences

Diabetic Dyslipidemia: Causes and Consequences Division of Preventive Medicine and Nutrition, Columbia University College of Physicians and Surgeons, New York, New York 10032 Search for other works by this author on: The Journal of Clinical Endocrinology & Metabolism, Volume 86, Issue 3, 1 March 2001, Pages 965971, Ira J. Goldberg; Diabetic Dyslipidemia: Causes and Consequences, The Journal of Clinical Endocrinology & Metabolism, Volume 86, Issue 3, 1 March 2001, Pages 965971, More cardiovascular disease occurs in patients with either type 1 or 2 diabetes. The link between diabetes and atherosclerosis is, however, not completely understood. Among the metabolic abnormalities that commonly accompany diabetes are disturbances in the production and clearance of plasma lipoproteins. Moreover, development of dyslipidemia may be a harbinger of future diabetes. A characteristic pattern, termed diabetic dyslipidemia, consists of low high density lipoprotein (HDL), increased triglycerides, and postprandial lipemia. This pattern is most frequently seen in type 2 diabetes and may be a treatable risk factor for subsequent cardiovascular disease. The pathophysiological alterations in diabetes that lead to this dyslipidemia will be reviewed in this article. Causes of lipoprotein abnormalities in diabetes Defects in insulin action and hyperglycemia could lead to changes in plasma lipoproteins in patients with diabetes. Alternatively, especially in the case of type 2 diabetes, the obesity/insulin-resistant metabolic disarray that is at the root of this form of diabetes could, itself, lead to lipid abnormalities exclusive of hyperglycemia. Type 1 diabetes, previously termed insulin-dependent diabetes mellitus, provides a much clearer understanding of the relationship among diabetes, ins Continue reading >>

How Triglycerides Affect Your Risk Of Diabetes

How Triglycerides Affect Your Risk Of Diabetes

No one wants type 2 diabetes. It’s a condition that affects your whole body and gets progressively worse, possibly leading to loss of vision and feeling (especially in your feet and fingertips), as well as kidney disease and heart disease. Having high triglycerides makes it more likely that you will develop diabetes, though. Luckily, with some effort, you have a good chance of lowering your triglycerides -- which, at the same time, can help you lower your chance of getting diabetes. High triglycerides don't cause diabetes. Instead, their levels indicate that your system for turning food into energy isn't working properly. Normally, your body makes insulin, which “escorts” glucose -- the type of sugar in your blood --inside your cells. There, your body turns glucose into energy. Insulin also allows your body to use triglycerides for energy. A common cause of high triglycerides is excess carbohydrates in your diet. High TG’s signals insulin resistance; that’s when you have excess insulin and blood sugar isn’t responding in normal ways to insulin. This results in higher than normal blood sugar levels. If you have insulin resistance, you’re one step closer to type 2 diabetes. If you also are overweight, eat a lot of sugary and starchy foods, or don’t exercise, your insulin resistance can be worse. You can reverse your tracks by following the exercise and meal plan your doctor recommends to lower your triglycerides and by taking prescribed medicine. Your doctor can check your blood sugar (also called glucose) levels, by taking a sample of your blood after you’ve fasted, which means you haven’t eaten for at least 8 hours. The doctor may also test the level of glucose in your blood with a special blood test called A1c. The result shows the average level of Continue reading >>

Mechanism Of Development Of Hyperlipidaemia In Diabetes Mellitus

Mechanism Of Development Of Hyperlipidaemia In Diabetes Mellitus

hypertriglyceridaemia dominant hyperlidaemia in diabetes mellitus lipoprotein lipase is activated by insulin - therefore insulin resistance and/or insulin deficiency may result in extremely elevated triglyceride levels (occasionally more than 100 mmol/L); diabetic patients who develop extremely high levels of triglycerides may already have a pre-existing partial defect in triglyceride catabolism e.g. apo E2 homozygote - in this case may also develop striate palmar xanthomata and tuberoeruptive xanthomata if glycaemic control is reasonable and hypertriglyceridaemia is still present then this is due to an overproduction of VLDL by the liver increased levels of non-esterified fatty acids (NEFA) are released if there is an increased quantity of adipose tissue (obesity) which often occurs in type II diabetes - this in turn probably leads to increased VLDL production hormone-sensitive lipase (within adipocytes) is inhibited by insulin (this hydrolyses triglyceride to produce NEFA and glycerol); therefore in insulin deficiency/resistance increased levels of NEFA are released from adipocytes; also there will be lowered levels triglyceride clearance as a result of reduced activation of lipoprotein lipase insulin has a direct inhibitory effect on VLDL production by hepatocytes - thus in insulin resistance and/or insulin deficiency triglyceride release by the liver will be further faciliated - note that even in insulin treated diabetes the liver is likely to be still insulin deficient because subcutaneously administered insulin reaches the liver via the systemic circulation (and not the portal vein) type 1 diabetics are less likely to have hypertriglyceridaemia than type 2 diabetics - this is because insulin therapy is the rule in type 1 diabetes and other factors that predispose Continue reading >>

Dietary And Drug Treatment Of Hyperlipidemia In Diabetes

Dietary And Drug Treatment Of Hyperlipidemia In Diabetes

Abstract Diabetics have increased risk of ASCVD and patients with ASCVD have increased incidence of diabetes. Patients with diabetes are susceptible to hypertriglyceridemia, particularly if they are obese maturity-onset diabetics. Elevated plasma triglycerides may constitute a greater risk factor for ASCVD than elevated plasma cholesterol in diabetics. The classification of hyperlipidemia can be made on the basis of plasma cholesterol and triglyceride concentration measured in the fasting state. Hypercholesterolemia (type II) or hypertriglyceridemia with or without hypercholesterolemia (type IV) will comprise the great majority of hyperlipidemias. The treatment of hyperlipidemia in diabetics is uncertain because most dietary and drug studies have centered about cholesterol rather than Trigrycerides, and most such studies have excluded diabetics. It is necessary, then, to assume that treatment ppropriate for nondiabetics is also appropriate for diabetics. The first order of treatment is restoration of body weight to ideal, as Is usually the case, it exceeds ideal weight. If weight reduction fails to bring about normal lipids, modest reduction of total dietary fat, of saturated fat, and slight increase in nsaturated fat and decrease in dletary cholesterol is worth a trial regardless of type of lipidemia. Although this diet is aimed chiefly at reduction of cholesterol it either does not change or may even decrease the plasma triglyceride concentration. Carbohydrates should be in the complex form with high fiber content. If hypertriglyceridemia persists despite the above measures, limited evidence suggests that restriction of dietary carbohydrate to 40 or 30 per cent of calories with a corresponding increase in fat may be effective. If the added fat is polyunsaturated the c Continue reading >>

Get Unlimited Access On Medscape.

Get Unlimited Access On Medscape.

You’ve become the New York Times and the Wall Street Journal of medicine. A must-read every morning. ” Continue reading >>

Primary Hyperlipidemia, Acute Pancreatitis And Ketoacidosis In An Adolescent With Type 2 Diabetes

Primary Hyperlipidemia, Acute Pancreatitis And Ketoacidosis In An Adolescent With Type 2 Diabetes

Krisztina Lukacs1,2*, Laszlo Jozsef Barkai1, Nora Hosszufalusi1, Eva Palik1, Attila J Szabo2 and Laszlo Madacsy2 13rd Department of Medicine, Semmelweis University, 1125 Budapest, Hungary 21st Department of Pediatrics, Semmelweis University, 1083 Budapest, Hungary Citation: Lukacs K, Barkai LJ, Hosszufalusi N, Palik E, Szabo AJ, et al. (2016) Primary Hyperlipidemia, Acute Pancreatitis and ketoacidosis in an Adolescent with Type 2 Diabetes. J Diabetes Metab 7:651. doi:10.4172/2155-6156.1000651 Copyright: © 2016 Lukacs K, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Visit for more related articles at Journal of Diabetes & Metabolism Abstract A case is presented of a 15-year-old boy with a past medical history of hyperlipidemia and hypertension. He attended the emergency department with a 3-day history of vomiting, acute abdominal pain, and altered mental status. Laboratory data on admission revealed metabolic acidosis (pH: 7.12, BE: -20.8 mmol/L), high blood glucose level (32.1 mmol/L) and significant hyperlipidemia (cholesterol: 16.3 mmol/L, triglycerides: 21.1 mmol/L). Treatment with electrolytes and volume replacement and intravenous insulin successfully resolved the ketoacidosis, but the abdominal pain and hyperlipidemia remained. Abdominal US and CT scan showed severe necrotizing pancreatitis with a pseudocyst. The laboratory studies showed a Frederickson type V pattern hyperlipidemia. HbA1c was 14.3% (133 mmol/mol), indicating the presence of chronic glucose elevation. Based on the lack of islet cell antibodies and the normal fasting serum C-peptide level, type 2 diabete Continue reading >>

Diabetes And Atherosclerosis: Is There A Role For Hyperglycemia?

Diabetes And Atherosclerosis: Is There A Role For Hyperglycemia?

Abstract Atherosclerosis is accelerated in both type 1 and type 2 diabetes. The hallmark of diabetes is the presence of hyperglycemia. In this article, we review the role of glucose in the pathogenesis of atherosclerosis. Evidence obtained from epidemiological, in vitro, and animal studies will be reviewed in an attempt to understand the complex relationship between hyperglycemia and cardiovascular risk that is emerging from clinical trials. EPIDEMIOLOGICAL EVIDENCE SUPPORTS AN ASSOCIATION BETWEEN GLYCEMIC CONTROL AND CARDIOVASCULAR DISEASE Strong epidemiological evidence supports an association between glycemic control and CVD risk (4). The United Kingdom Prospective Diabetes Study (UKPDS) provided additional insights into the relationship between glycemic control and CVD in patients with type 2 diabetes, indicating a linear relationship between HbA1c and CVD endpoints, particularly myocardial infarction (5). However, the slope of the relationship between HbA1c and microvascular complications is much steeper that than for myocardial infarction, raising the question of whether glucose plays a greater role in the pathogenesis of microvascular than cardiovascular complications of diabetes. Similar but less-robust relationships have been observed in patients with type 1 diabetes (6). However, epidemiological studies only indicate associations, and provide no evidence of causality. Therefore, other approaches are necessary to understand the potential role of hyperglycemia in the pathogenesis of cardiovascular disease. STUDIES ON ISOLATED VASCULAR CELLS SUGGEST THAT ELEVATED GLUCOSE LEVELS CAUSE A PLETHORA OF PROATHEROGENIC RESPONSES, BUT THE IN VIVO RELEVANCE OF MOST OF THESE FINDINGS AWAIT VERIFICATION Although in vitro studies have provided important insights into potenti Continue reading >>

Diseases Linked To High Cholesterol

Diseases Linked To High Cholesterol

High cholesterol is associated with an elevated risk of cardiovascular disease. That can include coronary heart disease, stroke, and peripheral vascular disease. High cholesterol has also been linked to diabetes and high blood pressure. To prevent or manage these conditions, work with your doctor to see what steps you need to take to lower your cholesterol. The main risk from high cholesterol is coronary heart disease. If the cholesterol level is too high, cholesterol can build up in the walls of your arteries. Over time, this build-up -- called plaque -- causes hardening of the arteries or atherosclerosis. This causes arteries to become narrowed, which slows the blood flow to the heart muscle. Reduced blood flow can result in angina (chest pain) or in a heart attack if a blood vessel gets blocked completely. Atherosclerosis causes arteries that lead to the brain to become narrowed and even blocked. If a vessel carrying blood to the brain is blocked completely, you could have a stroke High cholesterol also has been linked to peripheral vascular disease. This refers to diseases of blood vessels outside the heart and brain. In this condition, fatty deposits build up along artery walls and affect blood circulation. This occurs mainly in arteries that lead to the legs and feet. Diabetes can upset the balance between HDL and LDL cholesterol levels. People with diabetes tend to have LDL particles that stick to arteries and damage blood vessel walls more easily. Glucose (a type of sugar) attaches to lipoproteins (a cholesterol-protein package that enables cholesterol to travel through blood). Sugarcoated LDL remains in the bloodstream longer and may lead to the formation of plaque. People with diabetes tend to have low HDL and high triglyceride (another kind of blood fat) leve Continue reading >>

Secondary Causes Of Dyslipidemia

Secondary Causes Of Dyslipidemia

INTRODUCTION In many patients, hyperlipidemia is caused by some underlying "nonlipid" etiology rather than a primary disorder of lipid metabolism. The secondary causes of dyslipidemia will be reviewed briefly here (table 1). Primary lipid disorders are discussed separately. (See "Familial hypercholesterolemia in adults: Overview" and "Inherited disorders of LDL-cholesterol metabolism other than familial hypercholesterolemia" and "Hypertriglyceridemia".) PREVALENCE Dyslipidemia due to secondary causes is common. In a cohort of 824 new patients referred to a lipid clinic at an academic medical center in the United States, 28 percent had one or more potential causes of secondary dyslipidemia [1]. The most common conditions that were felt to be contributing to dyslipidemia were excessive alcohol intake (10 percent) and uncontrolled diabetes mellitus (8 percent). DIABETES MELLITUS Hyperlipidemia in association with insulin resistance is common in patients with type 2 diabetes mellitus [2,3]. Insulin resistance and the ensuing hyperinsulinemia are associated with hypertriglyceridemia, increased low-density lipoprotein (LDL), and low serum high-density lipoprotein (HDL) cholesterol concentrations. (See "Overview of medical care in adults with diabetes mellitus", section on 'Dyslipidemia'.) The lipoprotein abnormalities are related to the severity of the insulin resistance. A study that measured insulin sensitivity using a euglycemic clamp in patients with and without type 2 diabetes mellitus found that greater insulin resistance was associated with larger very low-density lipoprotein (VLDL) particle size, smaller LDL particle size, and smaller HDL particle size [4]. Additionally, the number of VLDL, intermediate-density lipoprotein (IDL), and LDL particles increase with increa Continue reading >>

Diabetes, High Blood Pressure And Cholesterol: How One Condition Impacts The Other

Diabetes, High Blood Pressure And Cholesterol: How One Condition Impacts The Other

I was diagnosed with Diabetes Type II in 1999. Prior to that date my blood pressure readings were averaging 147/91. In January of 2000 my doctor put me on Lipitor. Could my HBP be considered a secondary condition that is likely to be caused in part and/or aggravated by the diabetes mellitus? Multiple readers have noted that they have one combination or another of hypertension, type 2 diabetes mellitus and hyperlipidemia (elevated cholesterol, or triglycerides, or low HDL cholesterol) and asked which came first and whether one is secondary to the other. The relationship is often complex as each can not only worsen the other but also increases the effect upon the adverse problems that can lead to heart disease. In the question that I am answering, the blood pressures were already elevated and we would at least call them “pre hypertensive” before. The reason that we use the term “pre hypertensive” is that people who run high pressure early in life are more likely than others to run even higher pressures as they age. Indeed, the likelihood of having high blood pressure is quite low before age thirty but increases with each decade of life. One of the reasons that blood pressure increases as we get older is arteriosclerosis. Our arteries are quite compliant and expand with each push of blood pumping from the heart. The arteries become a bit stiffer as we age (come to think of it, so are our joints), and no longer cushion the shock of blood coursing through under pressure from the heart. This stiffness causes the pressure within the blood vessels to rise, and this is what we actually measure. As we age, in a “Western” society our unhealthy diets lead us to deposit fat molecules (mostly forms of cholesterol) into the walls of the blood vessels building up “plaque Continue reading >>

Cholesterol Abnormalities & Diabetes

Cholesterol Abnormalities & Diabetes

Cholesterol is a waxy substance that is made by the body and found in some animal-based foods. Blood cholesterol levels describe a group of fats also known as lipoproteins which includes HDL-C, or "good" cholesterol and LDL-C or "bad" cholesterol. Cholesterol is important to overall health, but when levels are too high, cholesterol can be harmful by contributing to narrowed or blocked arteries. Unfortunately, people with diabetes are more prone to having unhealthy high cholesterol levels, which contributes to cardiovascular disease (CVD). By taking steps to manage cholesterol, individuals can reduce their chance of cardiovascular disease and premature death. Using a blood sample taken after a brief period of fasting by the patient, a lipoprotein profile reveals the following lipid measures: Low-density-lipoprotein (LDL) cholesterol = "bad" cholesterol A high LDL-C level is associated with a higher risk for CVD. However, your LDL number should no longer be the main factor in guiding treatment to prevent heart attack and stroke, according to the latest guidelines from the American Heart Association. For patients taking statins, it’s important to work with your doctor to manage your LDL appropriately. A diet high in saturated and trans fats can raise your LDL cholesterol. High-density-lipoprotein (HDL) cholesterol = "good" cholesterol With HDL-C, higher levels are associated with a lower risk for CVD. Low HDL cholesterol puts you at higher risk for heart disease. People with high blood triglycerides usually also have lower HDL cholesterol. Genetic factors, type 2 diabetes, and certain drugs, such as beta-blockers and anabolic steroids, also lower HDL cholesterol levels. Smoking, being overweight and being sedentary can all contribute to lower HDL cholesterol. Triglycerid Continue reading >>

Hyperlipidaemia In Diabetes

Hyperlipidaemia In Diabetes

Atherosclerosis and its complications are a major cause of mortality and morbidity among patients with type 2 diabetes. This increased risk of cardiovascular complications has many causes including dyslipidaemia*, hypertension and smoking. Hyperglycaemia and hyperinsulinaemia may also contribute. Epidemiological evidence shows that there is a strong link between altered lipoproteins and the risk of coronary heart disease (CHD) in diabetes.1 There is a relationship between the incidence of CHD and the concentrations of total triglycerides and low density lipoprotein (LDL) cholesterol. There is an inverse relationship between CHD and high density lipoprotein (HDL) cholesterol. Lipid changes in diabetes Most studies show that patients with type 2 diabetes have more triglyceride and less HDL cholesterol (in particular, a lower HDL2 subfraction) than non-diabetics.2,3 These lipid abnormalities are also seen in non-diabetic individuals with increased obesity (in particular, an android or `upper body' fat distribution with increased visceral fat), hypertension and insulin resistance, hence leading to the recognition of the `metabolic syndrome' or `syndrome X'. Although the dyslipidaemia in diabetics appears to be greater, the non-diabetic people with the `metabolic syndrome' are also at an increased risk of CHD. While LDL cholesterol concentrations are usually similar in diabetic and non-diabetic populations, qualitative changes have been described. LDL particles have been shown to be smaller and denser in diabetics, which may enhance their atherogenicity.4 In non-diabetic populations, small dense LDL particles and apolipoprotein B (a component of LDL) have been shown to be independent risk factors for CHD. In type 1 diabetics, raised triglycerides (especially very low density Continue reading >>

Pathophysiology Of Hyperlipidemia In Diabetes Mellitus.

Pathophysiology Of Hyperlipidemia In Diabetes Mellitus.

Abstract Many lipoprotein abnormalities are seen in the untreated, hyperglycemic diabetic patient. The non-insulin-dependent diabetic (NIDDM) patient with mild fasting hyperglycemia commonly has mild hypertriglyceridemia due to overproduction of TG-rich lipoproteins in the liver, associated with decreased high-density lipoprotein (HDL) cholesterol levels. The more hyperglycemic untreated NIDDM and insulin-dependent diabetic (IDDM) patient have mild to moderate hypertriglyceridemia due to decreased adipose tissue and muscle lipoprotein lipase, (LPL) activity. These patients also have decreased HDL cholesterol levels associated with defective LPL catabolism of TG-rich lipoproteins. Treatment of diabetes with oral sulfonylureas or insulin corrects most of the hypertriglyceridemia and some of the decrease in HDL cholesterol. The abnormality in adipose tissue LPL activity corrects slowly over several months of therapy. The treated IDDM patient often has normal lipoprotein levels. The treated NIDDM patient may continue to have mild hypertriglyceridemia, increased intermediate-density lipoprotein levels, small dense low-density lipoproteins (LDL) with increased apoprotein B, and decreased HDL cholesterol levels. The central, abdominal distribution of adipose tissue in IDDM is associated with insulin resistance, hypertension, and the above lipoprotein abnormalities. Improvement in glucose control, in the absence of weight gain, leads to lower triglyceride and higher HDL cholesterol levels. In addition, the diabetic patient is prone to develop other defects that, in themselves, lead to hyperlipidemia, such as proteinuria, hypothyroidism, and hypertension, treated with thiazide diuretics and beta-adrenergic-blocking agents. When a diabetic patient independently inherits a common Continue reading >>

More in diabetes