For people with diabetes, high cholesterol can also be a big problem. The longer that a person with diabetes has out-of-control blood sugar levels, the more likely that the person will have narrowing of the arteries, the blood vessels that carry blood all over the body. Narrow arteries can lead to high cholesterol, which can contribute to strokes and heart attacks. In fact, diseases related to the heart and blood vessels are the leading causes of death for people with diabetes. Prevention is Key Blood sugar levels. The best way to help your cholesterol is to prevent problems with your blood sugar levels in the first place. Keep a log of your blood sugar levels when you test at home. If you notice any problems, it may be time for you and your doctor to check if your diet and medicines need to be changed. Lipid (cholesterol) testing. The American Diabetes Association advises that people with diabetes get tested for any cholesterol issues at least once a year. Your doctor, however, may want to have your cholesterol levels checked more often, depending on past results and other health issues, especially since there are no warning signs for high cholesterol most of the time. Cholesterol testing requires that you do not eat or drink (also known as fasting) for at least eight hours. Talk with you doctor if you have any concerns about fasting.