10 Causes of High Triglycerides in Diabetes

What Causes Elevated Levels?

It's not surprising to have high triglyceride levels if you have type 2 diabetes. Up to 70% of people with diabetes have this problem. Elevated triglyceride levels are also a component of metabolic syndrome, a group of disorders that increase your risk of heart disease, stroke, and type 2 diabetes. Other symptoms of this syndrome include high blood sugar, high blood pressure, low HDL (good cholesterol), and excess belly fat.

causes of high triglycerides in diabetes
Illustration by Emily Roberts, Verywell


Triglycerides are fat molecules that make up most of your body fat and the fat found in food. Along with cholesterol, they are one of the lipids that circulate in your blood. The medical term for having elevated levels of triglycerides is hypertriglyceridemia.

In fasting laboratory tests, a normal triglyceride level is below 150 milligrams per deciliter (mg/dL). Borderline high is 150 to 199 mg/dL. High is considered 200 to 499 mg/dL. Very high is over 500 mg/dL.

High triglyceride levels can increase your risk for heart disease, stroke, and nerve damage. There is a link between chronically elevated triglyceride levels and atherosclerosis, as well as insulin resistance.

Causes of High Triglycerides

There are many causes of high triglyceride levels. The list below includes common causes for people who have type 2 diabetes and related problems:

Poorly-controlled type 2 diabetes: When your diabetes is not well-managed, you are more likely to have high levels of both glucose (blood sugar) and insulin in your body. Insulin helps convert glucose into glycogen (the stored form of glucose) and helps to store glycogen in the liver. When the liver becomes too saturated with glycogen, though, glucose is instead used to create fatty acids that are released into the bloodstream. These fatty acids are used to make triglycerides, which build up in fat cells and contribute to body fat.​

Eating more calories than you burn: Triglycerides are used as a quick energy source between meals. Leftover calories are stored in your body cells as triglycerides.

High carbohydrate intake: When you eat foods with carbohydrates, the digestive system breaks the food down and extracts glucose. The glucose is then absorbed through the intestines into the bloodstream. As described above with poorly controlled diabetes, excess glucose can be used to make triglycerides. Carbohydrates come from milk/yogurt, grains (bread, pasta, rice), starchy vegetables (potatoes, peas, corn), legumes, fruit, sugary foods - sweetened beverages, cookies, cakes, candy. Not all carbohydrates are unhealthy foods, however, if you overeat carbohydrates your triglycerides can increase. 

Obesity: Being obese or overweight is not a guarantee that you will develop high levels of triglycerides, but there is a correlation between obesity and hypertriglyceridemia. There is a stronger correlation between excess waist circumference and high levels of triglycerides than with body mass index.

Insulin resistance: Insulin resistance occurs when your body does not respond to the insulin you make—as a result, sugar cannot enter the cells and instead remains in the bloodstream. Being resistant to the action of insulin contributes to high levels of both insulin and glucose and can lead to uncontrolled diabetes. Of course, uncontrolled diabetes can lead to high triglycerides, as described above.

Renal failure: The risk of chronic renal (kidney) failure is increased in people with diabetes. In fact, diabetes is one of the most common cause. Renal failure causes problems with the regulation of blood fats and results in high triglyceride levels. This could be due to increased triglyceride production, or the inability to clear them from the bloodstream, or both. Renal failure can also cause or worsen insulin resistance.

Genetics: Problems with high triglycerides can run in families. If this is the case, affected family members may have xanthelasma, or yellowish fatty deposits under the skin. A 2012 study found that low HDL cholesterol and high triglyceride levels due to genetic predisposition is related to increased risk for type 2 diabetes.

Low thyroid hormone levels: Thyroid disorders appear to have a higher prevalence in people with diabetes. The most common disorder is an underactive thyroid or hypothyroidism. If you have both high triglyceride and cholesterol levels, it might be a sign of low thyroid hormone levels. Ask your healthcare provider about ruling out this disorder. Treatment for hypothyroidism may help lower triglyceride levels.

Medications: Certain medications, such as birth control pills, estrogen, beta blockers, diuretics, steroids, retinoids, protease inhibitors, and Tamoxifen, can increase triglyceride levels. If you are taking one or more of these medications, talk to your healthcare provider about treatment options. Do not stop taking these medications without your healthcare provider's guidance.

Food and Beverages: Certain foods and beverages seem to affect triglyceride levels more than others. When you have diabetes, your body has less of a tolerance for these types of foods. These foods include simple sugars, such as sweetened beverages, cookies, cakes, candy, refined processed grains like white bagels and white pasta, alcohol, and foods high in fat, especially those high in saturated and trans fats (processed meat — sausage, bacon, bologna, sweets, fried foods).

How to Lower Triglyceride Levels

These tactics are recommended by the American Heart Association:

  • Exercise
  • Eat a healthy diet low in carbohydrate, sugar, saturated fat and trans fat 
  • Eat an adequate amount of heart-healthy fat - fatty fish, nuts, seeds, avocado, olive oil
  • If you smoke, work to quit
  • Get your blood sugars to target 
  • Limit your alcohol intake
  • Talk to your healthcare provider about trying medications or supplements like fish oil if the above lifestyle changes are ineffective or if your high triglyceride levels are genetic
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6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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