Checking your cholesterol (blood fats)

Your cholesterol should be checked during your yearly diabetes review. Find out why it’s important.  

Your GP or nurse will do a cholesterol test, which is a blood test using a needle and a syringe or by pricking your finger, to check:

• your overall cholesterol level
• the amount of your “bad” cholesterol (low-density lipoprotein, or LDL)
• the amount of your “good” cholesterol (high-density lipoprotein, or HDL)
• the ratio of total cholesterol to HDL cholesterol (cholesterol: HDL ratio)
• other fatty substances (triglycerides) in your blood

Some labs also now report the non-HDL cholesterol level, which includes other parts of “bad” cholesterol known as IDL, VLDL and lipoprotein(a).

Unless you are injecting insulin you shouldn’t eat for 10 to 12 hours before the cholesterol test, usually including when you're asleep at night, to make sure all food is digested and won't affect your results.

How diabetes increases the risk of cardiovascular disease

If your cholesterol levels, blood pressure and blood sugar levels are all high, your risk of heart disease known as cardiovascular disease (CVD) increases, which mainly leads to damaged blood vessels.

However, this risk can be cut a lot by getting your sugar (HbA1c), blood pressure and cholesterol levels within the ideal range. Reducing LDL cholesterol, increasing HDL cholesterol and having a lower cholesterol: HDL ratio will lower your CVD risk.

Find out about what lifestyle changes reduce your CVD risk.

Making lifestyle changes to reduce your CVD risk

You can make a difference to your cholesterol by making lifestyle changes.

Losing weight, even a 5% reduction in weight, will have a significant impact on increasing your HDL levels. Do this by cutting your carbohydrate intake (especially bread, rice, pasta and potatoes).

Change your diet as eating plenty of green vegetables and berries, oily fish, poultry, seeds and nuts will improve your cholesterol. Monounsaturated fats, like olive oil, reduce LDL. Omega-3 fats found in oily fish such as salmon and mackerel as well as walnuts and flax seeds boost HDL level.

Cut out trans fats because they raise overall cholesterol levels. Trans fats, sometimes listed on food labels as "partially hydrogenated vegetable oil," are often used in margarines and biscuits, crackers and cakes.

Increase your fibre intake as this reduces the absorption of cholesterol into your bloodstream. Soluble fibre is found in foods such as kidney beans, brussels sprouts, oatmeal, apples and pears. However, oatmeal, apples and pears also contain carbohydrates, so avoid eating too much of these, and avoid drinking apple juice.

Increase activities like brisk walking, which boost HDL levels. Aerobic exercise (the kind that really increases your heart rate and gets you sweating) seems to have the added bonus of encouraging HDL's anti-inflammatory activity and reducing CVD risk, even if the HDL levels don't go up much.

Quit smoking because smokers have lower HDL levels than non-smokers. Levels bounce back up once people quit.

Cut back on alcohol despite the fact that alcohol increases HDL, and the more people drink, the higher it goes up. Alcoholics tend to have greater HDL numbers, but the bad effects of high alcohol intake swamp any benefit from a high HDL.

Taking medication for your cholesterol

If you have diabetes and are over the age of 40 or have existing CVD and are younger than 40, you will almost certainly benefit from taking a statin to reduce your CVD risk. Statins reduce cholesterol production in the liver as well as having a number of other effects.

Your doctor or nurse is likely to start you on a medicine called atorvastatin, and usually at 20mg. If you think you are having any bad side effects, talk to your doctor, as your dose or the type of statin you take may need to change.

Discover our Learning Zone to find out more about programmes and interactive content that can help make some simple healthy tweaks.