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What Does Elevated Cholesterol And Blood Sugar Levels Under Treatment Indicate?
Question: Dear Doctor,
I am 45 years old, 6 feet height and 94 Kg person. Two years back (May 2012) while undergoing a routine checkup, the Cardiologist declared that I had a mild heart attack during past two days. I was not aware about any such incident and did not have any chest pain or something. The Angiogram revealed OM2 to have 50% stenosis. I was also declared to have dyslipidemia. For last two years I have been under medication. At the time of incident I used to smoke 15 cigarettes daily but in May 2013 I quit smoking. Just after quitting smoking I gained 8-10 kg weight within 2 months. Consulted Doctor but no satisfactory answer. My Lipid profile on 17th Jan2014 had S. Cholesterol - 255, S. HDL Direct -45, S. Triglicerides-244, S. LDL Direct -99. But the recent 5 days back profile revealed Triglycerides of 750 and Fasting Blood Sugar level of 323. This is very disturbing because under regular treatment and exercising regularly I was expecting the cholesterol to improve. Rather than improving now Sugar level has also gone up. Please note that I was never having diabetes. In fact in my whole family nobody have diabetes or heart disease. The only thing I was doing these days was having alcohol on higher side but can alcohol do this sudden hike of Sugar and Triglycerides level? My HBA1C shows 10.6 value. Please guide.
I am 45 years old, 6 feet height and 94 Kg person. Two years back (May 2012) while undergoing a routine checkup, the Cardiologist declared that I had a mild heart attack during past two days. I was not aware about any such incident and did not have any chest pain or something. The Angiogram revealed OM2 to have 50% stenosis. I was also declared to have dyslipidemia. For last two years I have been under medication. At the time of incident I used to smoke 15 cigarettes daily but in May 2013 I quit smoking. Just after quitting smoking I gained 8-10 kg weight within 2 months. Consulted Doctor but no satisfactory answer. My Lipid profile on 17th Jan2014 had S. Cholesterol - 255, S. HDL Direct -45, S. Triglicerides-244, S. LDL Direct -99. But the recent 5 days back profile revealed Triglycerides of 750 and Fasting Blood Sugar level of 323. This is very disturbing because under regular treatment and exercising regularly I was expecting the cholesterol to improve. Rather than improving now Sugar level has also gone up. Please note that I was never having diabetes. In fact in my whole family nobody have diabetes or heart disease. The only thing I was doing these days was having alcohol on higher side but can alcohol do this sudden hike of Sugar and Triglycerides level? My HBA1C shows 10.6 value. Please guide.
Brief Answer:
Hi Mr. XXXXXXX
Detailed Answer:
Hi Mr. XXXXXXX
Welcome to Healthcaremagic forum.
Let me explain your query one by one.
There appears to be recent onset diabetes in your case as fasting sugar and HbA1c both have been found to be raised.
There is high chances of Type II Diabetes Mellitus is your case which runs in family while few variations are acceptable (as in your case while family history for diabetes is negative).
Incidence of heart attack in May 2012 can be better judged by treating doctor by examine the ECG. Kindly send ECG picture as attached file, if possible.
Although you were taking statins (lipid lowering medicines) for dyslipidemia but intake of alcohol and uncontrolled sugar may worsen lipid level in blood and may give high triglycerides level.
You should again cross check the lipid profile levels from another local laboratory.
Treatment of Dyslipidemia (deranged lipid profile) is decided by presence / absence of risk factors.
Smoking, age > 45 years, sedentary life, first degree relative with positive early heart disease 140/90 mm Hg, Diabetes are considered as risk factors.
Treatment of Dyslipidemia is decided by LDL level and should read ATP III guidelines.
If < 2 risk factors are present then LDL should be < 160 mg%.
If > 2 risk factors with 10 year risk of developing heart disease is <20% then LDL should be <130 mg%.
If > 2 risk factors with 10 year risk of developing heart disease is >20%, diabetes then LDL should be <100 mg%.
You can download calculator from following site: http://www.nhlbi.nih.gov/guidelines/cholesterol
For very high risk patients and diabetic patients, LDL should be < 70 mg%.
For better future and life, you should consult with Internal medicine specialist/ cardiologist/ Endocrinologist and should go for regular check up.
You should quit alcohol with your inner will as you have done for smoking.
Your fasting sugar and postprandial sugar must remain in normal limits. Fasting sugar must be below 110 mg% and PP must be within 150-180 mg%.
LDL levels must be below 70 mg% with controlled Triglycerides level.
In my personal opinion, you should take Lipicard-AV in spite of Lipicard under guidance of your treating doctor.
Life style modifications are required in your case.
You should take low fat diet and live physically active life.
You should continue brisk exercise 30 minutes per day, at least 5 days in a week.
Hope that helps.
Let me know if I can address any more concerns.
Take care,
Dr. Mayank Bhargava
Hi Mr. XXXXXXX
Detailed Answer:
Hi Mr. XXXXXXX
Welcome to Healthcaremagic forum.
Let me explain your query one by one.
There appears to be recent onset diabetes in your case as fasting sugar and HbA1c both have been found to be raised.
There is high chances of Type II Diabetes Mellitus is your case which runs in family while few variations are acceptable (as in your case while family history for diabetes is negative).
Incidence of heart attack in May 2012 can be better judged by treating doctor by examine the ECG. Kindly send ECG picture as attached file, if possible.
Although you were taking statins (lipid lowering medicines) for dyslipidemia but intake of alcohol and uncontrolled sugar may worsen lipid level in blood and may give high triglycerides level.
You should again cross check the lipid profile levels from another local laboratory.
Treatment of Dyslipidemia (deranged lipid profile) is decided by presence / absence of risk factors.
Smoking, age > 45 years, sedentary life, first degree relative with positive early heart disease 140/90 mm Hg, Diabetes are considered as risk factors.
Treatment of Dyslipidemia is decided by LDL level and should read ATP III guidelines.
If < 2 risk factors are present then LDL should be < 160 mg%.
If > 2 risk factors with 10 year risk of developing heart disease is <20% then LDL should be <130 mg%.
If > 2 risk factors with 10 year risk of developing heart disease is >20%, diabetes then LDL should be <100 mg%.
You can download calculator from following site: http://www.nhlbi.nih.gov/guidelines/cholesterol
For very high risk patients and diabetic patients, LDL should be < 70 mg%.
For better future and life, you should consult with Internal medicine specialist/ cardiologist/ Endocrinologist and should go for regular check up.
You should quit alcohol with your inner will as you have done for smoking.
Your fasting sugar and postprandial sugar must remain in normal limits. Fasting sugar must be below 110 mg% and PP must be within 150-180 mg%.
LDL levels must be below 70 mg% with controlled Triglycerides level.
In my personal opinion, you should take Lipicard-AV in spite of Lipicard under guidance of your treating doctor.
Life style modifications are required in your case.
You should take low fat diet and live physically active life.
You should continue brisk exercise 30 minutes per day, at least 5 days in a week.
Hope that helps.
Let me know if I can address any more concerns.
Take care,
Dr. Mayank Bhargava
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Doctor,
Glad to hear from you. Will take necessary precautions as suggested by you. As I mentioned what can be the reason of sudden weight gain (8-10 Kg), as mentioned by me? & once I am detected for diabetes, can i permanently cured with medication for some time or now I will be a Diabetic forever?
Glad to hear from you. Will take necessary precautions as suggested by you. As I mentioned what can be the reason of sudden weight gain (8-10 Kg), as mentioned by me? & once I am detected for diabetes, can i permanently cured with medication for some time or now I will be a Diabetic forever?
Brief Answer:
Hi,
Detailed Answer:
Hi,
Alcohols are considered as high calorie beverages and increased intake may cause fat deposition in belly and increased weight gain.
Or we can say in other words that probably increased weight gain may be a cause of your diabetes.
Increased weight gain causes desensitization of abdominal fat cells with increase in blood sugar level and deranged lipid profile as a consequences.
Try to reduce weight with blood sugar in normal limits.
It's very difficult to say about the future of Type II diabetes at this point of time. Medication adherence and lifestyle change are key. You can still enjoy life being diabetic. It is all about bringing discipline in style and diet. Weight reduction may help you in control of blood sugar with lesser amount of medications.
Sincerely,
Dr. Mayank Bhargava
Hi,
Detailed Answer:
Hi,
Alcohols are considered as high calorie beverages and increased intake may cause fat deposition in belly and increased weight gain.
Or we can say in other words that probably increased weight gain may be a cause of your diabetes.
Increased weight gain causes desensitization of abdominal fat cells with increase in blood sugar level and deranged lipid profile as a consequences.
Try to reduce weight with blood sugar in normal limits.
It's very difficult to say about the future of Type II diabetes at this point of time. Medication adherence and lifestyle change are key. You can still enjoy life being diabetic. It is all about bringing discipline in style and diet. Weight reduction may help you in control of blood sugar with lesser amount of medications.
Sincerely,
Dr. Mayank Bhargava
Note: For further follow-up, discuss your blood glucose reports with our diabetologist. Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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