If you are a type 2 diabetic and your LDL numbers start to climb, chances are your physician will want you to take a statin drug. These potent cholesterol-lowering medications, however, can have side effects, including the breakdown of muscle tissue and memory loss, so you may want to ask your doctor for a different test.

LDL stands for low-density lipoprotein and is often called "bad" cholesterol because it is said it raises your risk of heart problems and other blood vessel complications. It is low-density because particles of LDL cholesterol are relatively large compared to HDL or high-density cholesterol. It is lipoprotein because, as a fat, cholesterol does not mix with the water that makes up blood plasma. The fat has to be enclosed in a coating of protein that is soluble in your blood.

Not all kinds of cholesterol are created equal. Great, big fluffy particles of LDL cholesterol are too large to get stuck in the linings of arteries. Only slightly smaller particles of LDL cholesterol called APO-B actually get trapped in your blood vessel walls.

No scientific study confirms that LDL levels are a reliable predictor of risk for heart attacks and stroke in type 2 diabetics. The kind of fat in the blood that really needs to get measured is APO-B. Before you commit to any long-term use of a medication that can cause muscle damage and memory loss, don't you want to be sure you really need it?

Another thing diabetics need to know about LDL is that the number on the lab report isn't really a measurement of LDL. It's an estimate of LDL. The lab actually measures total cholesterol, HDL (small particles of cholesterol), and triglycerides (particles used to make LDL cholesterol). The measurement assumes that everything else is LDL.

However, it might not be. Especially if you have been taking omega-3 fatty acids or you have been very careful about your diabetic diet, the number your doctor gets back from the lab may be erroneously high.

According to the US government, your LDL should be below 100 mg/dl (2.6 mmol/l) if you have diabetes and many scientists are now pushing for stricter standards, including reductions to below 70 mg/dl (1.8 mmol/l) for high risk patients. Some authorities have even called for lowering your LDL by 30 to 40% regardless of what your starting level is.

Ask your doctor about the validity of your cholesterol measurements. Why not check and see if your health care plan will cover testing for APO-B. Make sure you are treating a condition you really have.

Would you like more information about alternative ways to handle your type 2 diabetes?

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