Diabetes and high cholesterol may often occur together. High blood sugar and cholesterol levels increase the risk of stroke and heart attack. But a healthy diet and lifestyle can help you control these.

If you’ve been diagnosed with diabetes, you know that controlling your blood sugar levels is important. The more you can keep these levels down, the lower your risk of developing cardiovascular disease and other health problems.

Having diabetes puts you at a higher risk of developing high cholesterol. As you watch your blood sugar numbers, watch your cholesterol numbers, too.

Here, we explain why these two conditions often occur together and how you can manage both with practical lifestyle approaches.

If you have both diabetes and high cholesterol, you’re not alone. The American Heart Association (AHA)Trusted Source states that diabetes often lowers HDL (good) cholesterol levels and raises triglycerides and LDL (bad) cholesterol levels. Both of these increase the risk of heart disease and stroke.

According to the American Diabetes Association (ADA), these cholesterol amounts are healthy:

  • A total cholesterol level of around 150 mg/dL is considered optimal.
  • An LDL (“bad”) cholesterol level of below 100 mg/dL is considered optimal.
  • An HDL (“good”) cholesterol level of at least 40 mg/dL in men and 50 mg/dL in women is considered optimal.
  • Another important measure is your triglycerides. A triglyceride level of less than 150 mg/dL is considered optimal.

High cholesterol levels can be dangerous. Cholesterol is a type of fat that can build up inside the arteries. Over time, it can harden to form a stiff plaque. That damages arteries, making them stiff and narrow and inhibiting blood flow. The heart has to work harder to pump blood, and the risk of heart attack and stroke goes up.

Researchers don’t have all the answers yet and continue to grapple with how diabetes and high cholesterol are related, but bood sugar, insulin, and cholesterol all interact with and are affected by each other in the body. Having type 2 diabetes may increase your riskTrusted Source of having high cholesterol.

Meanwhile, what’s important is that you’re aware of the combination between the two. Even if you keep your blood sugar levels under control, your LDL cholesterol levels may still go up. However, you can control both of these conditions with medications and good lifestyle habits.

The main goal is to reduce your risk of heart disease and stroke. By following these tips, you’ll be giving your body what it needs to stay healthy and active.

You already know that it’s important to watch your blood sugar levels. It’s time to watch your cholesterol numbers, as well. As mentioned previously, an LDL cholesterol level of 100 or less is ideal. Follow your doctor’s instructions on keeping your blood sugar levels under control.

Be sure to check on your other numbers during your annual doctor visits. These include your triglycerides and blood pressure levels. In general, a healthy blood pressure is 120/80 mmHg.

Recommendations for optimal blood pressure for individuals with diabetes are that those with diabetes aim for a blood pressure of less than 130/80 mmHg. Total triglycerides should be less than 150 mg/dLTrusted Source.

There are some well-known lifestyle choices that clearly reduce the risk Trusted Sourceof cardiovascular disease. You probably know all of these, but just be sure that you’re doing everything you can to follow them:

  • Quit smoking, or don’t start smoking.
  • Follow a heart-healthy diet.
  • Lower your cholesterol if necessary.
  • Take all your medications as directed.
  • Maintain a healthy weight, or lose weight if you need to.
  • Limit alcohol.
  • Stay active.

As someone with diabetes, you already know that exercise is key for keeping your blood sugar levels under control.

Exercise is also key for managing high cholesterol. It can help increase HDL cholesterol levels, which are protective against heart disease, and, in some cases, reduce LDL cholesterol levels.

Probably the most effective exercise for controlling blood sugar levels is taking a walk after eating a meal.

A review of studies found that taking a walk as soon as possible after a meal was better at lowering blood sugar than a delayed walk after a meal or exercise before eating.

Walking is good for high cholesterol, too. In an older 2013 studyTrusted Source, researchers reported that walking reduced high cholesterol by 7%, whereas running reduced it by 4.3%.

In addition to walking after meals, aerobic exercise for about 30 minutes daily five times a week can be an important partTrusted Source of your plan to optimize cholesterol levels.

Try to incorporate some vigorous walking, biking, swimming, or tennis into your routine. Take the stairs, ride your bike to work, or get together with a buddy to play a sport.

Aerobic exercise is also beneficial for people with diabetes.

An older study published in PLOS OneTrusted Source in 2012 reported that exercise training helped reduce HbA1c levels in participants with type 2 diabetes. Another older studyfound that exercise training helped reduce waist circumference and HbA1c levels.

As we age, we naturally lose muscle tone. That’s not good for our overall health or for our cardiovascular health. You can resist that change by adding some weight training to your weekly schedule.

According to a 2023 review of studiesTrusted Source, the AHA recommends resistance training and found that it has the potential to improve HDL cholesterol, total cholesterol, and triglycerides. They also found that resistance training is beneficial for individuals with diabetes.

The AHA found that resistance training is beneficial for overall health. It has the potential to lower blood pressure, improve cholesterol, and improve insulin sensitivity.

You’ve probably already made changes in your diet to help keep your blood sugar levels low. You’re controlling the amount of carbs you eat at each meal, choosing foods low on the GI, and eating small meals more regularly.

If you also have high cholesterol, this diet will still work for you, with just a few small modifications. Continue to limit unhealthy fats such as those in red meat and full-fat dairy, and choose more heart-friendly fats like those found in lean meats, nuts, fish, olive oil, avocadoes, and flax seeds.

Then, simply add more fiber to your diet. Soluble fiber is the most important, as it may help lower LDL cholesterol. Oats, bran, fruits, beans, lentils, and vegetables are examples of foods that contain soluble fiber.

Even if you’re careful about controlling both your blood sugar and your blood cholesterol, diabetes can affect other parts of the body over time. That means it’s important to stay on top of all facets of your health as you go.

  • Your eyes: Both high cholesterol and diabetes can affect your eye health, so be sure to see your eye doctor every year for a checkup.
  • Your feet: Diabetes can affect the nerves in your feet, making them less sensitive. Check your feet regularly for any blisters, sores, or swelling, and make sure that any wounds heal as they’re supposed to. If they don’t, check with your doctor.
  • Your teeth: There is some evidence that diabetes can increase the risk of gum infections. See your dentist regularly and practice careful oral care.
  • Your immune system: As we age, our immune system gradually weakens. Other conditions like diabetes can weaken it even more, so it’s important to get your vaccinations as you need them. Get your flu shot each year, ask about the shingles vaccine after you turn 60, and ask about the pneumonia shot after you turn 65. The Centers for Disease Control and Prevention (CDC)Trusted Source also recommends that you get your hepatitis B vaccination soon after you’re diagnosed with diabetes, as people with diabetes have higher rates of hepatitis B.

Diabetes and high cholesterol can often occur together, but there are ways to manage both conditions. Maintaining a healthy lifestyle and monitoring your cholesterol levels when you have diabetes are important ways of managing both conditions.