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Q: My triglycerides are 288, LDL is 106, HDL is 42, total serum cholesterol is 206 and fasting glucose is 98. Am I considered diabetic? Or pre diabetic? Is there anything I can do reduce these numbers?
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Mary Pickett, M.D.

Mary Pickett, M.D., is an Associate professor at Oregon Health & Science University where she is a primary care doctor for adults. She supervises and educates residents in the field of Internal Medicine, for outpatient and hospital care. She is a Lecturer for Harvard Medical School and a Senior Medical Editor for Harvard Health Publications.

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June 30, 2009
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A:

With a fasting blood sugar (glucose) lower than 100, you are not considered diabetic or pre-diabetic. Your number is in the normal, expected range.

For people who are at low risk for heart disease, an LDL level lower than 130 milligrams per deciliter (mg/dL) is acceptable. An HDL level above 40 is reasonable but less than an ideal HDL of 60 or more.

Your triglycerides are above the suggested normal of 150 (assuming you were fasting for the test). There is some debate about the importance of a slightly elevated triglyceride level and increased heart attack risk.

High triglycerides can improve if you make changes in your diet to reduce your calorie intake, consume less alcohol, get some added exercise and lose weight.

With high triglycerides, you may want to ask your doctor to calculate your "non-HDL" cholesterol. This is another method of using your numbers to calculate your heart risk. The non-HDL cholesterol number factors in another type of cholesterol called "very low density lipoprotein." Your non-HDL cholesterol should be no more than 30 points higher than your goal for LDL. For most people, the non-HDL goal is less than 160mg/dL. If you have a high non-HDL calculation, you might consider taking a cholesterol medicine.

Your doctor may also wish to check your thyroid function. Sometimes low thyroid function is a cause of higher triglycerides.

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