Diabetes is on a fast rise in India. The pathology of the disease needs to be understood by the patients in order for them to combat the disease. Pathologically diabetes is intrinsically linked to lipids (fats), its types and their levels. Cholesterol and triglycerides are two types of lipids which play a role in diabetes.
Cholesterol and triglycerides are two types of lipids which play a role in diabetes.
Cholesterol is made by the liver and then carried by blood to the cells of the body. Although cholesterol is important for many functions in the body, its high levels can be very damaging. Cholesterol cannot be eliminated from the body. It just circulates from the liver to cells and back. High density lipoprotein (HDL) cholesterol is famously called the “good” cholesterol and this is because it carries cholesterol from the cells to the liver so that liver does not make new cholesterol. While Low density lipoprotein (LDL) is called “bad” cholesterol as it binds to cholesterol, preventing its removal from the cells. Thus, cholesterol deposits in the cells and arteries.
Low density lipoprotein (LDL) is called “bad” cholesterol as it binds to cholesterol, preventing its removal from the cells. Thus, cholesterol deposits in the cells and arteries.
Deposition of lipids mainly occurs in the central abdominal region giving rise to a specific type of obesity called ‘’Central Obesity’’. The Asian Indian diabetic is thus called the thin fat Indian with low muscle mass and high fat mass distributed abdominally. Such fat cells undergo a pathological transformation and have a disrupted function. They become insensitive to insulin and as a consequence cannot remove sugar from the blood leading to diabetes. The lipids that deposit in the arteries form an atherosclerotic plaque causing narrowing of the arteries. Coronaries, which are the arteries of the heart get narrowed or occluded in this way and hence lipids are a major risk factor for cardiovascular diseases also. Triglycerides are composed of fatty acids and although are not directly linked to diabetes, are associated with increased risk for cardiovascular diseases. Hence it is important that a patient with diabetes regularly has their lipid profiles checked.
A lipid profile establishes the current levels of the different lipids like HDL, LDL, HDL to LDL ratio, total cholesterol and triglycerides in the body. It is important to maintain not just healthy levels of blood sugar in diabetes but also a healthy lipid profile because of its connection to cardiovascular diseases.
The role of diet and physical activity is central to living a healthy life while living with diabetes. Diet should aim to control carbohydrates which are a source of blood sugar and cholesterol rich foods. Counting your carbohydrates and consuming healthy carbs from legumes, vegetables, nuts and avoiding drinks with artificial sugars and sweets is necessary. Cutting out high- fat animal proteins, dairy products and cooking your food in olive oil instead of monosaturated oils and butter is essential to reduce cholesterol consumption. Eating soluble fibers like oats and barley, fishes like salmon and tuna, and fruits like avocado help decrease cholesterol in the body. A good diet has to be complemented with regular exercise and this two-pronged approach goes a long way in maintaining a healthy lipid profile in diabetes.
Diabetes is a chronic disease with several consequences. A strict maintenance of the lipid profile with the help of your doctor can limit these consequences. The mantra of regular check –ups, diet and exercise can make the way for a diabetic to live a healthy life.
(Dr Rusina Karia is a doctor by profession. She did her MBBS from Maharasthra, India and went on to do her research fellowship from Midwest Cardiovascular Research Foundation, Iowa. She is the author of various research publications published in different renowned journals.)