Ask The Expert
Medications

Lipitor is a drug designed to control your blood fats-also called lipids. Specifically, Lipitor is in the class of drugs called "statin" drugs (generic name: atorvastatin), which is considered one of the medications of choice for people with diabetes who have high cholesterol. Statins inhibit the production of cholesterol in the liver, especially LDL cholesterol (also known as the "bad" cholesterol, which deposits in the walls of arteries and can lead to heart disease and strokes). Statins also help the liver remove cholesterol from the blood.

What Causes High Cholesterol and other Lipids?

In essence, many people have abnormal blood lipids, caused by poorly controlled diabetes, poor dietary habits, inadequate exercise, excess weight, aging, and heredity.

You accumulate cholesterol in two ways: 1) your body produces it; 2) you get it from eating certain animal products that are high in saturated fat, such as meats, eggs, cheese, milk, butter, and to a lesser extent, poultry and fish. In addition, the press has focused on trans fats, which cause your body to make more cholesterol. Trans fats are contained in some vegetable oils, cookies, crackers, snack foods, and in general, processed foods. The FDA recently announced that food labels must now include the amount of trans fats contained in each food product.

"Fat terminology"-such as saturated fat, polyunsaturated ft, monounsaturated fat, trans fat, hydrogenation, cholesterol, triglycerides, HDL, and LDL-can be confusing, so be sure to read more about these in the links provided at the end of this answer.

When blood fats accumulate, they can cause a buildup in the lining of the blood vessels-called "plaque" which can interfere with blood flow especially to the heart and brain, as well as to the legs and feet.

Treatment involves: careful meal planning and exercise, and often, a lipid-lowering drug. There are a variety of drugs used to treat lipids, and each category targets lipids in a different manner:

• Statins, as already mentioned, inhibit the production of cholesterol in the liver, especially LDL cholesterol. Statins also help the liver remove cholesterol from the blood.
• Fibric Acid Derivatives target the lowering of triglycerides, and also raise HDL levels (known as the good cholesterol, which helps carry cholesterol away from the arteries to the liver, where it can be removed by the body).
• Nicotinic Acid (Niacin) lowers total and LDL cholesterol, raises HDL, and lowers triglycerides.
• Resins bind bile acids and prevent them from recycling through the liver. Because the liver needs cholesterol to make bile, it increases its uptake of cholesterol from the blood.
  

Final Reminders:

• If you haven't already done so, ask your doctor to refer you to both a diabetes educator and a dietitian, who can assess your current meal and activity plan and make appropriate recommendations.
  • To find an educator: The American Association of Diabetes Educators (AADE) is a multidisciplinary organization representing over 11,000 healthcare professionals who provide diabetes education and care.
  • To find a dietitian: The American Dietetic Association's Nationwide Nutrition Network is a national referral service that links consumers, physicians, food manufacturers, distributors or restaurant owners or managers with dietetics professionals.
• Although many people use lipid-lowering drugs, each person can respond differently, and some people have side effects. It is important to discuss this with your doctor, and to be sure to have regular lab tests.
• As always, discuss all this with your healthcare team.