Treatment of High Cholesterol and Diabetes Mellitus

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Diabetes Mellitus and High Cholesterol

Although diabetes mellitus and high cholesterol may occur independently of one another, often times these may coexist in many patients. This is because risk factors for each of these are common to both of these conditions such as diet, lack of exercise, stress, age and family history. The risk from complications and death also increases when they coexist in an individual.

High blood sugar levels are the hallmark of diabetes mellitus. In type 1 diabetes (juvenile onset type) the hormone insulin is completely lacking and therefore there is failure of sugar utilization. Individuals who suffer from type 2 diabetes on the other hand are usually older adults, and have a relatively insufficient amount of insulin and/or a resistance of cells to the effects of insulin. Neither type of diabetics can handle a diet with high sugar content.

High cholesterol is a condition where excess fatty substances are deposited in the walls of the arteries and put a patient at risk for heart disease and stroke. Although normal amounts of cholesterol are need by the body for cell building and function, an excess of it is definitely dangerous to health. Therefore, an imbalance between the levels of good cholesterol and bad cholesterol influences the increase in these risks.

Treatment of Diabetes and High Cholesterol

Obesity is often a risk factor for acquiring high cholesterol and sugar levels, although not all obese people are diabetic. A diet with high fat and sugar content is often the culprit for developing these and treatment therefore consists of addressing these coexisting conditions. Modifying one’s diet to one with a low calorie, low fat and low carbohydrate content is most ideal in starting and maintaining treatment of diabetes and high cholesterol levels. Increasing the intake of fiber in fruits and vegetables is also key to improving weight and blood sugar and cholesterol levels.

Regular exercise is highly recommended to reduce both blood sugar and blood cholesterol levels. Exercise induces greater utilization of glucose and fat in providing energy for cells. In particular, aerobic exercise improves the sensitivity of muscle and fat cells to the effects of insulin thus decreasing sugar levels in the blood. It also prevents the development of vascular complications like stroke and heart failure from high cholesterol by decreasing the levels of bad cholesterol while increasing that of good cholesterol.

Aside from modification of lifestyle, medical treatment may be needed in many patients whose conditions cannot be managed by these alone. Medications include:

For high blood sugar levels:

Oral hypoglycemic agents like sulfonylureas – these drugs stimulate the release of insulin from the pancreas to decrease blood sugar levels. Examples are Micronase, DiaBeta and Glucotrol

Meglitinides – short acting drugs that stimulate insulin release. Examples are Prandin and Starlix.

Biguanides like metformin (Glucophage) – decrease glucose release from liver and helps improve insulin sensitivity of cells.

Thiazolidinediones – improve the cells sensitivity to the effects of insulin and in the redistribution of fat cells but does not increase insulin secretion. However, Rosiglitazone (Avandia), an example of this type of drug, has been investigated for its cardiovascular side effects and its use is thus under regulation by the FDA. Another example, Pioglitazone (Actos), is also effective in reducing triglyceride levels.

Alpha-glucosidase inhibitors like Acarbose (Precose) delay sugar absorption after meals and prevents a surge in blood sugar levels.

Insulin injections are ultimately needed by some patients whose treatment with oral hypoglycemic fail to work. Insulin works by increasing the absorption of glucose into cells for utilization as energy.

For high cholesterol:

Statins – drugs that reduce the levels of bad cholesterol (LDL) by blocking their synthesis. They also increase the levels of good cholesterol (HDL). Examples are Crestor, Lescol, Lipitor, Mevacor, Pravachol, and Zocor. Statins are currently the standard treatment for high cholesterol and are considered effective in reducing the risk for heart disease and stroke.

Other drugs that act by decreasing absorption of cholesterol are bile acid resins, ezetimibe (Zetia), fibric acid like Antara and niacin, available as Niacor.

Treatment of high cholesterol and diabetes mellitus often go hand-in-hand especially in the obese and in people who are at high risk for complications. Medical consultation is advised for proper evaluation and managment.

References

eMedicine, “Diabetes Mellitus, Type 2: Treatment & Medication” , https://emedicine.medscape.com/article/117853-treatment

WebMD, “High Cholesterol Treatment – What Works?”, https://www.webmd.com/cholesterol-management/features/high-cholesterol-treatment-what-works?page=2

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