Your Lipid Panel Doesn't Have to Be a Mystery
Staring at a page of numbers like LDL, HDL, and triglycerides can feel overwhelming, especially when you're already managing diabetes. We get it. That feeling of confusion and worry is exactly why we created this guide.
In this video, you will learn about the following:
- What triglycerides are (a form of fat in your bloodstream) and why they rise
- Why high triglycerides can raise the risk of pancreatitis, heart attack, and stroke
- The link between type 2 diabetes, insulin resistance, and higher triglycerides
- What “normal” looks like (less than 150 mg/dL) and when to talk to your care team
- Smart food moves, including cutting sugar/refined carbs and excess alcohol from your diet, while adding fiber and omega-3s
- Why a “low carb” diet doesn’t mean “high in saturated fat”
- The most effective treatments for elevated triglyceride levels
From Confusion to Confidence
Our goal is to help you cut through the medical jargon, understand what your numbers really mean for your health, and feel empowered to take the next step.
When you live with diabetes, a cholesterol report isn’t just another piece of paper—it’s a critical part of your health puzzle. But it’s easy to get lost in the alphabet soup of terms.
This is your moment of clarity. Dr. Edelman and Dr. Pettus translate the numbers into plain English. You’ll learn why triglycerides are so important for people with diabetes, and you’ll walk away with a clear, actionable plan – from food choices to medical treatments – to help you take back control of your health.
Understanding Your Report: What the Numbers Mean
Let's break down the key parts of your cholesterol report. No complex science, just the straight facts you need to know.
LDL
The “Lousy” Cholesterol
Think of this as the “bad” cholesterol. Its job is to build up and create plaque in your arteries (your body’s pipes). The goal is to get this number as Low as possible to keep those pipes clear.
HDL
The “Healthy” Cholesterol
This is the “good” cholesterol. It acts like a cleanup crew, helping remove the bad stuff from your system. You want this number to be as High as possible. (It’s often influenced by genetics).
Triglycerides
The Overlooked Number
This is a type of fat in your blood. For people with diabetes, high triglycerides are a major red flag for pancreatitis and heart disease risk. Getting this number under control is one of the most powerful things you can do for your long-term health.
Improving Your Numbers: A Practical Lifestyle Guide
Ready to take action? Here are simple, powerful tips you can start using today to improve your triglyceride levels.
Switch to healthier oils like avocado, olive, grapeseed, peanut, and safflower oil.
Reduce refined carbs like white bread, white rice, and flour tortillas.
Replace refined carbs with whole grains like brown rice, quinoa, and whole wheat bread.
Reduce processed meats like sausage, lunch meat, and red meat.
Choose lean proteins such as lean meat, turkey, chicken, tofu, and fish.
Moderate alcohol (not as much as Jeremy), as it can significantly raise triglyceride levels.
Consider a Mediterranean diet, which is easy to follow, and it also emphasizes whole foods and olive oil.
Exercise regularly, aiming for at least 30 minutes most days…and continue to build up!
When Lifestyle Isn't Enough: Medical Treatments
Sometimes, diet and exercise alone don't get the numbers where they need to be—and that's okay. Medical support is a crucial tool. Here are the options your doctor might discuss with you.
Weight Loss – Losing even a modest amount of weight can have a big impact on lowering triglycerides.
Controlled Blood Sugars – Keeping your A1c below 7% and maintaining stable blood sugars is one of the best ways to reduce triglycerides.
Maximum-Dose Statin – If you’re already on a statin for LDL, making sure it’s at the most effective dose is the first-line medical approach.
Medication: Fibrates – This is an older class of medications (like Gemfibrozil and Fenofibrate) used specifically to lower high triglycerides.
Medication: Fish Oil (Prescription) – High-dose, prescription-strength fish oil, like Vascepa, is proven to be effective. Over-the-counter supplements are not strong enough.
Medication: Olezarsen –A newer, specialized medication currently approved for an extremely rare, genetic triglyceride condition to reduce the risk of pancreatitis, but could have expanded use for a wider group of people with other types of elevated triglyceride conditions in the future.
Your Docs Who Get It
Steven Edelman and Dr. Jeremy Pettus aren’t just endocrinologists—they’re your guides on the journey of Taking Control Of Your Diabetes (TCOYD). Their mission is simple: to provide clear, entertaining, and empowering education that helps you live a healthier, happier life with diabetes.
No. It is usually normal.
How do you lower ldl?
I think mine are great 43 and I’m 82 yrs old hike almost everyday. I don’t eat out.I don’t use butter only plant base butter. We don’t have chips and jump food in our house .I”m type 2 have Tandem mobi pump.
Hi Vinny,
Dr. Edelman recently did a video with a nutritionist that touches on this topic here:
https://tcoyd.org/diabetes-triglycerides/
You can also find helpful info on the American Heart Association website here:
https://www.heart.org/en/health-topics/cholesterol/hdl-good-ldl-bad-cholesterol-and-triglycerides/lower-your-ldl
MY DR SAID MY CHOLESTEROL IS TOO LOW. WHY IS THAT A PROBLEM ? LAST LAB TEST SHOWED CHOLESTEROL 70 , LDL 18, HDL 32 TRIGLYCERIDE 99. I AM TYPE 2 AND HAVE BEEN SINCE MAY 1985. USE A LIBRE 3 CGM.
It’s not a problem being too low, unless your HDL, which is the protective cholesterol, is too low. 32 is probably below what you would have if you didn’t have type 2 diabetes, but there’s not much you can do about it because that’s part of the metabolic syndrome of type 2 diabetes. The thing to do is lower your LDL, and that helps reduce your risk. It’s very tough to raise your HDL. Exercise can help.
Very timely! Just got my results this week
HDL is 105, LDL is 91. But total is 211. Triglycerides are at 64. I’m an type 1 with 6.2 A1c on a vegetarian low carb diet..
I know my pcp will likely insist on statins for me. I don’t wanna just cos I don’t wanna.. do I really need to?
It’s true that the goal for people like you is an LDL below 70, however it’s important to take into account your very very high protective HDL. To have a ratio of basically one to one is extremely unusual, but very protective. So if you were my patient I would say you would not need to take a statin because your HDL is so protective.
I have read recent journal reports that very high HDL can be dangerous too. When I asked my endo, she didn’t seem to know about this. What do you think? My HDL is 103 and LDL is 73 without drugs. I am Type 1.
I’ve never heard that in my life. Stop reading Reader’s Digest. With that HDL and LDL, you’re going to live forever. Congratulations.
Excellent presentation on Triglycerides
Thanks Peggy…appreciate it.
My LDL is 80 as of 10-14 25. It was 116 in April. How do I get it down below 70. My heart dr wants mine below 70. Triglycerides are 108. Cholesterol is 163. HDL is 62
With those numbers, 80 is perfectly fine in my book, if you do not have any evidence of heart disease now, because the goal is less than 55 and the best way to get it down other than diet and exercise is low dose LDL-lowering drugs. Do not be afraid of them, because they are protective. Having an LDL of 80 and an HDL that’s high, I think you’re doing pretty well, but I am not your doctor.