Cholesterol is a waxy fat (lipid) that is present in all human beings. In modest amounts, cholesterol is necessary for good health. However, unhealthy levels of cholesterol are directly linked to hardening of the arteries (atherosclerosis), coronary artery disease, stroke and other cardiovascular conditions.

Keeping cholesterol levels healthy is especially important for people with diabetes because cardiovascular diseases are their leading cause of death. According to the American Diabetes Association, heart and other cardiovascular diseases occurs earlier and two to four more times more often in people with diabetes than in the general population.

The liver makes 80 percent of the body’s cholesterol. The rest is ingested from animal products such as meat, eggs and dairy foods. There are several forms of cholesterol, but the two most common types are low-density lipoproteins (LDL or “bad” cholesterol) and high-density lipoproteins (HDL or “good” cholesterol). Levels of other blood fats, including triglycerides, should also be watched closely. As with cholesterol, excess triglycerides are linked to heart disease and other cardiovascular disorders.

Cholesterol guidelines, like those regarding high blood pressure, are stricter for individuals with diabetes. The ADA generally advises people with diabetes to maintain cholesterol levels as follows, with measurements in milligrams per deciliter (mg/dL):

The National Cholesterol Education Program recommends total cholesterol levels of less than 200 mg/dL. These levels are diagnosed with a simple cholesterol blood test.

Two of the most important lifestyle changes to lower cholesterol, a nutritious diet and exercise, also help in controlling glucose (blood sugar). However, abnormal cholesterol levels can be difficult to manage and may require treatment with cholesterol-reducing drugs.