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What Causes High Triglycerides in Diabetes?

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Updated March 30, 2012

It's not surprising to have high triglyceride levels if you have type 2 diabetes. About 80% of people with diabetes struggle with this problem. Elevated triglyceride levels are a component of metabolic syndrome, a group of disorders that increase your risk for heart disease, stroke, and type 2 diabetes. Other components of this syndrome include high blood sugar, high blood pressure, low HDL (good cholesterol), and excess belly fat.

What are Triglycerides?

Triglycerides are fat molecules that can be found in your body. Along with cholesterol, they are one of the blood lipids. In fact, 99% of body fat is made up of triglycerides. The medical term for having elevated levels of triglycerides is hypertriglyceridemia.

In fasting laboratory tests, a normal triglyceride level is below 150 mg/dL. Borderline high is 150 to 199 mg/dL. High is considered 200 to 499 mg/dL. Very high is over 500 mg/dL.

High triglyceride levels can increase your risk for heart disease, stroke, and nerve damage. There is a link between chronically elevated triglyceride levels and atherosclerosis, as well as insulin resistance.

Causes of High Triglyceride Levels in Diabetes

There are many causes for high triglyceride levels. The list below includes common causes for people who have type 2 diabetes and related problems:

Poorly controlled type 2 diabetes: When your diabetes is not under good control, you likely have high levels of both glucose (blood sugar) and insulin in your body. Insulin helps convert glucose into glycogen (the stored form of glucose) and helps to store glycogen in the liver. When the liver becomes too saturated with glycogen, though, glucose is instead used to create fatty acids that are released into the bloodstream. These fatty acids are used to make triglycerides, which build up in fat cells and contribute to body fat.

Eating more calories than you burn: Triglycerides are used as a quick energy source between meals. Leftover calories are stored in your body cells as triglycerides.

High carbohydrate intake: When you eat foods with carbohydrates, the digestive system breaks the food down and extracts glucose. The glucose is then absorbed through the intestines into the bloodstream. As described above with poorly controlled diabetes, excess glucose can be used to make triglycerides.

Obesity: Being obese is not a guarantee that you will develop high levels of triglycerides, but there is a correlation between obesity and hypertriglyceridemia. There is a stronger correlation between excess waist circumference and high levels of triglycerides than with body mass index.

Insulin resistance: Being resistant to the action of insulin contributes to high levels of both insulin and glucose and can lead to uncontrolled diabetes. Of course, uncontrolled diabetes can lead to high triglycerides, as described above.

Renal failure: The risk for chronic renal (kidney) failure is increased in people with diabetes. In fact, diabetes is the most common cause. Renal failure causes problems with the regulation of blood fats and results in high triglyceride levels. This could be due to increased triglyceride production, or the inability to clear them from the bloodstream, or both. Renal failure can also cause or worsen insulin resistance.

Genetics: Problems with high triglycerides can run in families. If this is the case, affected family members may have xanthomas or yellowish fatty deposits under the skin. A 2012 study found that low HDL cholesterol and high triglyceride levels due to genetic predisposition is related to increased risk for type 2 diabetes.

Low thyroid hormone levels: Thyroid disorders appear to have a higher prevalence in people with diabetes. The most common disorder is an underactive thyroid, or hypothyroidism. If you have both high triglyceride and cholesterol levels, it might be a sign of low thyroid hormone levels. Ask your doctor about ruling out this disorder. Treatment for hypothyroidism may help lower triglyceride levels.

Medications: Certain medications, such as birth control pills, estrogen, beta blockers, diuretics, steroids, retinoids, protease inhibitors, and Tamoxifen, can increase triglyceride levels. If you are taking one or more of these medications, talk to your doctor about treatment options. Do not stop taking these medications without your doctor's guidance.

Food: Certain foods seem to affect triglyceride levels more than others. When you have diabetes, your body has less of a tolerance for these types of foods. These foods include simple sugars, refined processed grains, alcohol, and foods high in fat, especially those high in saturated and trans fats.

How to Lower Triglyceride Levels

  • Exercise
  • Eat a healthy diet low in carbohydrate, sugar, saturated fat and trans fat intake
  • If you smoke, work to quit
  • Get your diabetes under control
  • Limit your alcohol intake
  • Talk to your doctor about trying medications if the above lifestyle changes are ineffective or if your high triglyceride levels are genetic

Sources:

Pathophysiology of the Endocrine System, Physiologic Effects of Insulin. Colorado State University. Accessed: February 9, 2012. http://www.vivo.colostate.edu/hbooks/pathphys/endocrine/pancreas/insulin_phys.html

Qi, Qibin; Liang, Liming; Doria, Alessandro; Hu, Frank B; and Qi, Lu. "Genetic Predisposition to Dyslipidemia and Type 2 Diabetes Risk in Two Prospective Cohorts." Diabetes Feb 7 2012 61(3):745-752

Tackling Triglycerides: 8 Ways to Solve a Big Fat Problem. Harvard Health Publications. Accessed March 10, 2012. http://www.health.harvard.edu/press_releases/tackling-triglycerides

Triglycerides. American Heart Association. Accessed: March 5, 2012 http://www.heart.org/HEARTORG/GettingHealthy/NutritionCenter/Triglycerides_UCM_306029_Article.jsp#.T167BfUZ-dk

Vaziri, ND. "Dyslipidemia of Chronic Renal Failure: The Nature, Mechanisms, and Potential Consequences." Renal Physiol 2005 290(2):F262-F272

Wiggin, Timothy D; Sullivan, Kelli A; Pop-Busui, Rodica; Amato, Antonio; Sima, Anders AF; Feldman, Eva L. "Elevated Triglycerides Correlate with Progression of Diabetic Neuropathy." Diabetes July 2009 58(7):1634-40

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