10 Causes of High Triglycerides in Diabetes

What Causes Elevated Levels?

It's common to have high triglyceride levels if you have type 2 diabetes. When they are above the normal range, your provider might tell you that your triglyceride levels are elevated. Up to 70% of people with diabetes also have elevated triglyceride levels.

This article will go over how triglyceride levels are related to diabetes. You'll also learn how to lower your triglyceride levels if they're too high.

causes of high triglycerides in diabetes
Illustration by Emily Roberts, Verywell

Definition

Triglycerides are fat molecules. They're also called lipids. You get fat from the foods you eat, but your body also makes and stores fat. Triglycerides and cholesterol are fats that are in your blood.

The medical term for higher-than-normal triglyceride levels is hypertriglyceridemia.

If you are having your triglycerides levels checked, you will usually need to fast before the test. This means not eating for usually at least eight hours before your blood sample is taken.

Here are the results of a fasting triglyceride test:

  • Normal: Below 150 milligrams per deciliter (mg/dL)
  • Borderline High: 150 to 199 mg/dL
  • High: 200 to 499 mg/dL
  • Very High: Over 500 mg/dL

Having high triglyceride levels can increase your risk for heart disease, stroke, and nerve damage. Research has found a link between having elevated triglyceride levels for a long time and conditions like atherosclerosis and insulin resistance.

Recap

Triglycerides are fats in the blood. Normal levels are below 150mg/dL. If your levels are 200mg/dL or more, they are considered high. High triglycerides levels increase your risk of conditions like heart disease and stroke. People with type 2 diabetes and metabolic syndrome often have high triglyceride levels.

Causes of High Triglycerides

There are many causes of high triglyceride levels. People with certain health conditions or risk factors are more likely to have higher triglyceride levels.

For example, elevated triglyceride levels are common in people with metabolic syndrome. This group of disorders increases your risk of heart disease, stroke, and type 2 diabetes. The syndrome can also cause high blood sugar, high blood pressure, low HDL ("good" cholesterol), and extra belly fat.

People who have type 2 diabetes may have health concerns related to the condition that can affect their triglyceride levels.

Poorly-Controlled Type 2 Diabetes

Diabetes that is not well-managed leads to high levels of glucose (blood sugar) and insulin in the body. Insulin helps convert glucose into a form that can be stored (glycogen). It also helps store glycogen in the liver.

If the liver has too much glycogen in it, the body will use glucose to make the fatty acids. The acids are used to make triglycerides. When they get released into the bloodstream, they can build up in the fat cells and add to body fat.

Eating More Calories Than You Burn

Your body uses triglycerides as a quick energy source between meals. Leftover calories are stored in your cells as triglycerides.

High Carbohydrate Intake

When your body digests the food you eat, carbohydrates get broken down and glucose gets taken out. The glucose is then absorbed by the intestines and goes into the bloodstream.

If a person has poorly controlled diabetes, the extra glucose can be used to make triglycerides.

Carbohydrates come from foods like:

  • Dairy products (e.g., milk, yogurt)
  • Grains (e.g., bread, pasta, rice)
  • Starchy vegetables (e.g., potatoes, peas, corn)
  • Legumes
  • Fruit
  • Sugary foods (e.g. sweetened beverages, cookies, cakes, candy)

Carbohydrates aren't a "bad" food—they're a key part of a balanced diet. However, if you overeat carbohydrates, it can make your triglycerides go up.

Obesity

Obesity or being overweight does not mean you will definitely have high triglycerides. However, research has found there is a link between obesity and hypertriglyceridemia.

There appears to be a strong link between having a larger waist circumference and high levels of triglycerides. The link is not as strong between high triglycerides and body mass index (BMI).

BMI is a dated, flawed measure. It does not take into account factors such as body composition, ethnicity, sex, race, and age. 
Even though it is a biased measure, BMI is still widely used in the medical community because it’s an inexpensive and quick way to analyze a person’s potential health status and outcomes.

Insulin Resistance

Insulin resistance occurs when your body does not respond to the insulin you make. That means sugar cannot get into your cells. Instead, it stays in your bloodstream.

Being resistant to insulin leads to high levels of insulin and glucose. People who are not able to manage their diabetes well often have high levels of triglycerides.

Renal (Kidney) Failure

The risk of chronic kidney failure (also called renal failure) is higher in people with diabetes. In fact, diabetes is one of the most common causes of the condition.

In someone with kidney failure, the body has trouble controlling how much fat is in the blood because:

  • The body is making more triglycerides.
  • The body is not able able to clear fats from the blood.
  • Or both of these things happen at the same time.

Eventually, these problems cause a person's triglyceride levels to go up. Kidney failure can also cause insulin resistance or make it worse.

Genetics

High triglycerides can run in families. If you have family members with high triglyceride levels, you may notice they have yellowish fatty deposits under the skin called xanthelasma.

A 2012 study found that people with low HDL cholesterol and high triglyceride levels caused by a genetic predisposition had an increased risk for type 2 diabetes.

Low Thyroid Hormone Levels

Thyroid disorders are also common in people with diabetes. Many people with diabetes also have an underactive thyroid or hypothyroidism.

If you have both high triglyceride and high cholesterol levels, it might be a sign of low thyroid hormone levels.

It's important to talk to your provider if you think you might have a thyroid condition. In some cases, the treatment for hypothyroidism may help lower your triglyceride levels.

Medications

Certain medications can also increase triglyceride levels. Here are a few common medications that can raise triglyceride levels:

If you are taking a medication that you think might be contributing to your high triglyceride levels, talk to your healthcare provider. Do not stop taking your medications unless your provider tells you to.

Food and Beverages

Certain foods and beverages affect triglyceride levels more than others. In people with diabetes, the effect might be stronger because the body is less able to handle certain foods.

Foods that may contribute to high triglyceride levels include:

  • Simple sugars (e.g., sweetened beverages, cookies, cakes, candy)
  • Refined, processed grains (e.g., white bread and bagels; white pasta)
  • Foods high in fat—especially saturated and trans fats (e.g., processed meats like sausage, bacon, bologna; sweets, fried foods)
  • Alcohol

Recap

There are many causes of high triglycerides. If you have diabetes, the way that your body handles some foods (like carbohydrates and sugar) can contribute to high triglyceride levels. Other health conditions, medications, and genetics can also lead to triglyceride levels that are too high.

How to Lower Triglyceride Levels

There are some steps that you can take to try to lower your triglyceride levels. Here are a few ideas recommended by the American Heart Association.

  • Exercise regularly.
  • Eat a diet that's low in carbohydrates, sugar, saturated fat, and trans fat.
  • Include heart-healthy fats in your diet (e.g. from fatty fish like salmon, nuts, seeds, avocado, and olive oil).
  • Quit smoking or using tobacco products.
  • Limit your alcohol intake.
  • Get and keep your blood sugars within your target range.

If lifestyle changes don't help get your triglyceride levels down, talk to your healthcare provider. You might need to take medications or supplements to help lower your triglyceride levels—especially if they're high because of genetics.

Recap

Exercising, eating a nutritious diet with healthy fats, and controlling your blood sugar may help lower your triglyceride levels. If these lifestyle measures don't work, talk to your provider. There are also medications and supplements that can help get your triglyceride levels into a healthy range.

Summary

Triglycerides are a type of fat in your blood. When you eat more fat than your body needs for energy, it gets stored.

When you have high triglyceride levels, it means you have more fat in your blood than what will best support your health. High levels of triglycerides can increase your risk of having a stroke or heart disease.

There are many reasons that your triglycerides levels can be high. If you have type 2 diabetes, some reasons are related to the condition.

There are lifestyle changes you can make to lower your triglycerides. If needed, you can also take medications or supplements to help get them into the normal range.

A Word From Verywell

If you have type 2 diabetes, you're used to thinking about how much sugar is in your blood. You also need to know how much fat is in your blood. One type of fat is triglycerides and it's important to know your levels.

Having high levels of triglycerides is common in people with diabetes. That said, having high levels carries health risks. That's why it's important to work on getting your triglyceride levels to a healthy range and keeping them there, just as you do with your blood sugar.

Frequently Asked Questions

  • What are the symptoms of high blood sugar?

    The symptoms of high blood sugar (hyperglycemia) include blurred vision, dry skin, dry mouth, fatigue, weakness, and a frequent need to urinate. High blood sugar usually only affects people with diabetes. It is possible it can occur from heightened stress as a result of infection, taking certain medicine, surgery, or trauma, but blood sugar levels should go back to normal when the stress dissipates.

  • Which medicine helps lower triglyceride levels?

    Certain medicines like fibrates, nicotinic acid, omega-3 fatty acid, statins, and PCSK9 inhibitors. When natural methods of lowering triglyceride levels are ineffective, or if a person shows a heightened risk of cardiovascular disease, a healthcare provider may prescribe these medicines to help with management.

7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Parhofer KG. Interaction between glucose and lipid metabolism: More than diabetic dyslipidemia. Diabetes Metab J. 2015;39(5):353–362. doi:10.4093/dmj.2015.39.5.353

  2. Cleveland Clinic. Triglycerides.

  3. Feingold KR, Grunfeld C. Diabetes and dyslipidemia. 2019. In: Feingold KR, Anawalt B, Boyce A, et al., editors. Endotext. South Dartmouth (MA): MDText.com, Inc.

  4. Qi Q, Liang L, Doria A, Hu FB, Qi L. Genetic predisposition to dyslipidemia and type 2 diabetes risk in two prospective cohortsDiabetes. 2012;61(3):745–752. doi:10.2337/db11-1254

  5. American Heart Association. Triglycerides: Frequently Asked Questions.

  6. MedlinePlus. High Blood Sugar - Self-Care.

  7. National Heart, Lung, and Blood Institute. High Blood Triglycerides.

Additional Reading

By Elizabeth Woolley
Elizabeth Woolley is a patient advocate and writer who was diagnosed with type 2 diabetes.