This is a part of a series by advocate Susan Sloane about cholesterol. Read the other part of the series, Treating High Cholesterol: A Heart-Healthy Diet.

Susan B. Sloane, BS, RPh, CDE, has been a registered pharmacist for more than 20 years and a Certified Diabetes Educator for more than 15 years. Her two sons were diagnosed with diabetes, and since then, she has been dedicated to promoting wellness and optimal outcomes as a patient advocate, information expert, educator, and corporate partner.

While high cholesterol is a common issue among people with diabetes, treatment options vary.


Statins have been wildly popular since their inception over twenty years ago. Some doctors even use statins in treatment as a preventive measure because of their anti-inflammatory properties at the cellular level. And a study published in the Archives of Neurology suggests statins may reduce a person's risk of Parkinson's disease.

All is not perfect in the world of statins, however. There are potential risks, such as liver problems, muscle aches, and most recently, the possible increased risk for Alzheimer's disease. And, as a result of study data reviewed by the FDA and published in the Archives of Internal Medicine, all statins must carry warnings about an increased risk of hyperglycemia and possible memory/cognition issues.

The increased risk of elevated blood sugars was seen to the greatest extent in post-menopausal women. These studies were done in people without diabetes in most cases. Although a baseline liver enzyme test is still required before someone starts a statin, periodic liver enzyme levels do not need to be taken after the baseline test unless a person develops symptoms involving muscle weakness and pain.

I am not knocking statins. In fact, I take one myself. And the FDA is even looking at making these drugs available without a prescription. It is just important to be well informed and follow your healthcare teams’ recommendations for what is right for you.

If your doctor prescribes a statin, you will probably take one pill per day in the evening. This makes the drug work more efficiently because your body produces cholesterol at night. If you miss a dose, don’t double up; simply take your pill the next day as scheduled.

Periodic blood work will be done to measure cholesterol and liver enzymes, and it typically takes several weeks to see changes in cholesterol levels. If liver enzymes are elevated, your physician may decide to decrease the statin dose, change the statin, or discontinue treatment.

Side effects of statins may include cramping, gas, and constipation. If muscle weakness or soreness occurs, contact your doctor.

Soluble fiber

Soluble fiber for some people is a safe effective way of reducing cholesterol. Bran cereal and whole wheat bread have fiber, but they have insoluble fiber. Soluble fiber is found in foods such as oatmeal, oat bran, dried beans, barley, flaxseed, psyllium, and prunes.

Soluble fiber works to lower cholesterol by binding to cholesterol in the intestines. Fiber helps to lower LDL cholesterol primarily. Some studies say to aim for seven to 13 grams of soluble fiber daily to get an effect, but your own healthcare team will provide you with direction. Some people use products like Metamucil® to get their soluble fiber.

Fiber supplements can have some unpleasant side effects such as gas, bloating, and diarrhea. They can also decrease the absorption of some vitamins that are known as fat-soluble, which are vitamins A, D, E, and K. In addition, some people are allergic to psyllium. Signs of psyllium allergy include rash, itching, and shortness of breath.