Cholesterol guidelines for diabetics

What should my cholesterol be?

Following this question in a thread at the big forum noblehead posted the following:

noblehead wrote:
 These are the ideal cholesterol levels that they want people with diabetes to aim for:

• Your total cholesterol level should be below 4.0mmol/l.
  
• LDL levels should be less than 2.0mmol/l.
  
• HDL levels should be 1.0mmol/l or above in men and 1.2mmol/l or above in women.
  
• Triglyceride levels should be 1.7mmol/l or less.
  

There is no science behind these levels in fact they could be dangerous especially for women and not just older women.

In reality like many things is a U curve were the worst is the low cholesterol, but too high in man is also not as good as in the middle. The problem is that what is consider now "normal" is really lower that what is associated with better longevity. The U curve is more pronounced in men than in women, but as many other things it may have nothing to do with cholesterol and may just be an association with something else happening in the body. Very low cholesterol is associated with cancer and very high cholesterol may be indicative of some other problem like thyroid or cholesterol receptors problems both can greatly reduce longevity.

yoly wrote:In reality like many things is a U curve were the worst is the low cholesterol, but too high in man is also not as good as in the middle. The problem is that what is consider now "normal" is really lower that what is associated with better longevity. The U curve is more pronounced in men than in women, but as many other things it may have nothing to do with cholesterol and may just be an association with something else happening in the body. Very low cholesterol is associated with cancer and very high cholesterol may be indicative of some other problem like thyroid or cholesterol receptors problems both can greatly reduce longevity.

Interesting, I had my lipid profile tested yesterday

Total Cholesterol    115 mg/fl

LDL                       46.7 mg/dl

HDL                      54 mg/dl

Triglycerides           73 mg/dl

Fasting Blood Glucose  73 mg/dl

HbA1c 5.0%

All this with the compliments of the LCHF diet, but it DIDNT HAPPEN OVERNIGHT OF COURSE.

I have a long history of heart disease [26 years ] and it aint got me yet.

Pasha wrote:

yoly wrote:In reality like many things is a U curve were the worst is the low cholesterol, but too high in man is also not as good as in the middle. The problem is that what is consider now "normal" is really lower that what is associated with better longevity. The U curve is more pronounced in men than in women, but as many other things it may have nothing to do with cholesterol and may just be an association with something else happening in the body. Very low cholesterol is associated with cancer and very high cholesterol may be indicative of some other problem like thyroid or cholesterol receptors problems both can greatly reduce longevity.

Interesting, I had my lipid profile tested yesterday

Total Cholesterol    115 mg/fl

LDL                       46.7 mg/dl

HDL                      54 mg/dl

Triglycerides           73 mg/dl

Fasting Blood Glucose  73 mg/dl

HbA1c                    5.0%

All this with the compliments of the LCHF diet, but it DIDNT HAPPEN OVERNIGHT OF COURSE.

I have a long history of heart disease [26 years ] and it aint got me yet.

Great numbers Pasha. Cholesterol and what is good or bad has to be the most debated topic in the medical world for decades. I have high HDL and low trigs, the LDL is higher than recommended, I have refused to take statins and I am a heart job. This opened my eyes a few years ago and was the largest study ever undertaken on the subject. One thing is beyond doubt, the older we get, the higher the cholesterol numbers, the longer we live.

Eddie wrote:

Pasha wrote:

yoly wrote:In reality like many things is a U curve were the worst is the low cholesterol, but too high in man is also not as good as in the middle. The problem is that what is consider now "normal" is really lower that what is associated with better longevity. The U curve is more pronounced in men than in women, but as many other things it may have nothing to do with cholesterol and may just be an association with something else happening in the body. Very low cholesterol is associated with cancer and very high cholesterol may be indicative of some other problem like thyroid or cholesterol receptors problems both can greatly reduce longevity.

Interesting, I had my lipid profile tested yesterday

Total Cholesterol    115 mg/fl

LDL                       46.7 mg/dl

HDL                      54 mg/dl

Triglycerides           73 mg/dl

Fasting Blood Glucose  73 mg/dl

HbA1c                    5.0%

All this with the compliments of the LCHF diet, but it DIDNT HAPPEN OVERNIGHT OF COURSE.

I have a long history of heart disease [26 years ] and it aint got me yet.

Great numbers Pasha. Cholesterol and what is good or bad has to be the most debated topic in the medical world for decades. I have high HDL and low trigs, the LDL is higher than recommended, I have refused to take statins and I am a heart job. This opened my eyes a few years ago and was the largest study ever undertaken on the subject. One thing is beyond doubt, the older we get, the higher the cholesterol numbers, the longer we live.

I have an appointment with my cardiolog at the end of the month. Will discuss with him re Statin cessation . He admits that LDL is associated or linked to heart disease but that this is not causation.

I did a trial about 14 months ago where I stopped the statins for 3 months and the results were higher but still good, I think.

ie Total Cholesterol  176 mg/dl

HDL                       70 mg/dl

LDL                     91.6 mg/dl

Triglycerides           70 mg/dl

I think I shall now repeat this trial in a final effort to stop taking Statins. Maybe my body biochemistry has changed in the meantime ,who knows ?  This whole Statin issue pisses me off a bit because the medical profession cannot make up its mind.

In the military at least there is a saying "if there is a doubt then there is no doubt"

"In the military at least there is a saying "if there is a doubt then there is no doubt"

Same in the Aerospace industry. If there is doubt it's not good enough, maybe's and should be's ain't good enough. It's either right or it's wrong, no grey area.

My current opinion is that LDL is the body's repair system and is used to heal damage caused by inflammation which comes from glycation and many other sources. Ron Krauss's famous Small Dense LDL doesn't work properly as the particles are broken, fail to engage with the receptors, and are easily oxidised and glycated by exactly the same processes that damage the arteries in the first place.
Krauss found that the factor causing SDLDL is dietary carbohydrate, NOT fat (and he should be taken seriously being as how he is a past president of the AHA and could have made a perfectly adequate career out of regurgitating dogma, but preferred doing science, and has been carefully unpicking the "lipid hypothesis" and "diet-heart hypothesis".)
Not Krauss but someone with similar views found that the trigs/HDL ratio relates to
1. insulin resistance
2. cardiovascular risk
3. particle size and density of LDL
in UK numbers a ratio of 1.3 or less is good, 1.4 and upwards is Not Good.
While I dutifully ate my low fat diet my trigs/HDL ratio was nearly 7. On low carb it came down to under 1. LDL initially went up while I lost the dietician-caused weight, then came down again. Saturated fat without the carbs made the HDL increase and the LDL decrease by about the same amount. This is commonplace enough that I no longer worry what my LDL is.
Ask your cardiologist if he's ever heard of EPIC-Norfolk. This and other studies correlate cardiovascular risk with HbA1c. Not a lot of doctors know that.
Yoly is correct, low "cholesterol" is associated with higher death rates from other than CVD.

chris c wrote:My current opinion is that LDL is the body's repair system and is used to heal damage caused by inflammation which comes from glycation and many other sources. Ron Krauss's famous Small Dense LDL doesn't work properly as the particles are broken, fail to engage with the receptors, and are easily oxidised and glycated by exactly the same processes that damage the arteries in the first place.
Krauss found that the factor causing SDLDL is dietary carbohydrate, NOT fat (and he should be taken seriously being as how he is a past president of the AHA and could have made a perfectly adequate career out of regurgitating dogma, but preferred doing science, and has been carefully unpicking the "lipid hypothesis" and "diet-heart hypothesis".)
Not Krauss but someone with similar views found that the trigs/HDL ratio relates to
1. insulin resistance
2. cardiovascular risk
3. particle size and density of LDL
in UK numbers a ratio of 1.3 or less is good, 1.4 and upwards is Not Good.
While I dutifully ate my low fat diet my trigs/HDL ratio was nearly 7. On low carb it came down to under 1. LDL initially went up while I lost the dietician-caused weight, then came down again. Saturated fat without the carbs made the HDL increase and the LDL decrease by about the same amount. This is commonplace enough that I no longer worry what my LDL is.
Ask your cardiologist if he's ever heard of EPIC-Norfolk. This and other studies correlate cardiovascular risk with HbA1c. Not a lot of doctors know that.
Yoly is correct, low "cholesterol" is associated with higher death rates from other than CVD.

I am working from memory here, but I believe Ron Krauss was the first to measure cholesterol break downs using a centrifuge, these machine were taken up all over the world. He later discovered the so called bad cholesterol LDL was dependent on particle sizes i.e. large particles of LDL were not a problem. He re invented his machine and changed his techniques. The trouble is in the UK and many other countries LDL particle sizes cannot be measured, especially by the NHS. Therefore the info we receive is pretty useless. That being said the 'experts' have recently changed their opinion on LDL being a reason for concern.

Correct! The trigs/HDL ratio is a close approximation but many NHS doctors and especially nurses won't even "waste" the money on a full lipid panel.
One of the local nurses told me "we don't test your "cholesterol" again once you're on your statin". My GP has marginally more sense but try making an appointment to see her the same month you need to.
I think you can get a mail-order NMR or VAP from the States but it's not cheap.