# Raised cholesterol or blood sugar: first checks Canonical URL: https://www.hemed.com/blog/raised-cholesterol-or-blood-sugar-what-a-clinician-checks-first Plain-text URL: https://www.hemed.com/blog/raised-cholesterol-or-blood-sugar-what-a-clinician-checks-first/llms.txt Published: 2026-10-22 Modified: 2026-10-22 Author: The HeMed clinical team Topic: Conditions and risks Topic URL: https://www.hemed.com/blog/topic/conditions-and-risks Tags: Cholesterol and heart, Prediabetes, Blood markers Reading time: 11 min Publisher: HeMed (https://www.hemed.com/) ## Summary Your cholesterol or blood sugar came back raised. What a UK clinician checks first, what the numbers mean, the NHS route, and where a blood test fits. ## Article If a blood test has shown raised cholesterol or raised blood sugar, a clinician checks three things first. They are the full set of numbers behind the headline figure, your overall risk, and whether the result needs repeating. One number on its own is rarely a decision. In England in 2024, 45% of men had raised cholesterol, and 50% of women. The NHS says high cholesterol does not usually cause symptoms, and a blood test is the only way to find out if you have it. This guide sets out what "raised" means for each marker, what a clinician looks at next, the NHS routes and where weight comes in. It ends with how HeMed's blood test fits, and where its limits are. ### What counts as raised cholesterol? Raised cholesterol means one or more of the fats in your blood sit above the levels UK guidance treats as healthy. The NHS levels for adults are total cholesterol below 5 mmol/L, non-HDL cholesterol below 4 mmol/L and, for men, HDL above 1.0 mmol/L. #### What do LDL, HDL and non-HDL mean? LDL (low-density lipoprotein) is the kind that can clog your arteries. HDL (high-density lipoprotein) helps clear cholesterol out of them. Non-HDL is your total minus your HDL: all the "bad" cholesterol added together. HEART UK, the cholesterol charity, adds two more figures: LDL below 3 mmol/L, and triglycerides below 1.7 mmol/L fasting or below 2.0 mmol/L non-fasting. Triglycerides are a separate blood fat, measured alongside cholesterol. The unit, mmol/L, is millimoles per litre, the measure UK laboratories use. UK cholesterol levels for adults (population figures, each attributed) Measure | Level | Source Total cholesterol | Below 5 mmol/L | NHS Non-HDL cholesterol | Below 4 mmol/L | NHS HDL cholesterol (men) | Above 1.0 mmol/L | NHS LDL cholesterol | Below 3 mmol/L | HEART UK Triglycerides | Below 1.7 mmol/L fasting, below 2.0 mmol/L non-fasting | HEART UK A good target for you depends on your age, your health conditions and your overall risk of cardiovascular disease. That is why the same number can mean different things for two men. Our article on the warning signs of high cholesterol covers the risk factors that cluster in men. ### What counts as raised blood sugar? On a routine blood test, raised blood sugar usually means an HbA1c of 42 mmol/mol or more. HbA1c (glycated haemoglobin) reflects your average blood sugar over the previous two to three months, not the level on the day. HbA1c thresholds used in UK practice HbA1c | What it indicates | Source Below 42 mmol/mol | Within the normal range | Diabetes UK 42 to 47 mmol/mol | Non-diabetic hyperglycaemia, often called prediabetes: a high risk of type 2 diabetes | Diabetes UK 48 mmol/mol or above | The cut-off for diagnosing diabetes, confirmed by a repeat test in a person without symptoms | Diabetes UK Diabetes UK estimates that prediabetes affects around one in 12 people, and says there aren't usually any symptoms. Our article on prediabetes in men explains the 42 to 47 range and what lowers the risk of moving on to type 2 diabetes. ### Why does a clinician look at your overall risk, not one number? Because the chance of a heart attack or stroke depends on more than cholesterol. NICE, the body that writes NHS clinical guidance, recommends the QRISK3 tool to estimate 10-year risk for people aged 25 to 84 without cardiovascular disease. QRISK3 takes age, sex, ethnicity, smoking, diabetes, family history, blood pressure, body mass index and the cholesterol ratio, among other factors. NICE uses non-HDL cholesterol, not total cholesterol, as the measure for treatment decisions. Blood sugar works the same way: in a person without symptoms, one HbA1c of 48 mmol/mol or above is not a diagnosis. Diabetes UK says the test is repeated, and type 2 diabetes is confirmed only if the second result is also 48 or above. NICE says to prioritise people for a full risk assessment when their estimated 10-year risk is 10% or more. The NHS says your GP uses your cholesterol levels along with your age, blood pressure and health conditions to estimate your risk. A QRISK score may follow. This is why a clinician asks about blood pressure, smoking and family history before deciding anything. The result raises the question; your whole picture answers it. ### What happens next with raised cholesterol? The first step is a conversation with your GP about your overall risk. The NHS says you can lower your cholesterol by eating healthily and getting more exercise. It adds that some people also need to take medicine. The NHS says you might need medicine if your level has not gone down after changing your diet and lifestyle. The same applies if you are at high risk of a heart attack or stroke. Your GP makes that decision with you. If you have never had a cholesterol test, the NHS says to ask your GP surgery for one if you are over 40 or overweight. The same applies if high cholesterol or heart problems run in your family. Most people do not need to fast before the test. #### Who can have an NHS Health Check? In England, men aged 40 to 74 can have a free NHS Health Check every 5 years. It is for people without a diagnosed heart, kidney, diabetes or blood pressure condition, inherited high cholesterol, or a prescribed cholesterol-lowering medicine. It includes a cholesterol test and gives you a cardiovascular risk score. The risk behind a cholesterol figure is cardiovascular disease. Men are more likely to get it than women, and risk also rises with age, family history, ethnicity, diabetes, high blood pressure and high cholesterol. See a GP if you think you are at higher risk of having or getting cardiovascular disease. ### What happens next with raised blood sugar? An HbA1c of 42 to 47 mmol/mol is a prompt to act, not a diagnosis. Diabetes UK says people in this range should have their HbA1c checked again at least once a year. In England, the NHS Diabetes Prevention Programme (Healthier You) refers people at risk of type 2 diabetes onto a 9-month lifestyle change programme. It runs face to face and as a digital service. The ways in include the Diabetes UK Know Your Risk tool and the NHS Health Check. An HbA1c of 48 mmol/mol or above means a repeat test. If the second result is also 48 or above, the diagnosis is confirmed, and your GP takes it from there. ### Where does weight come in? Excess weight is linked to both. In England in 2024, 70% of men were overweight or living with obesity, against 62% of women. The NHS lists being overweight among the risk factors for high cholesterol. It also lists excess weight among the lifestyle factors that make cardiovascular disease more likely. NICE's guideline on overweight and obesity asks clinicians to identify conditions like these after the initial assessment. They should start managing them straight away, not after weight loss. Both results are also on the UK list of weight-related health conditions a prescriber may consider. They appear there as dyslipidaemia (abnormal blood fats) and as prediabetes or type 2 diabetes. #### How is weight measured? Weight itself is measured with BMI (body mass index), your weight in kilograms divided by your height in metres squared. NICE says to interpret it with caution. Below BMI 35, NICE adds waist-to-height ratio: keep your waist to less than half your height. Lower thresholds apply to some backgrounds. NICE classifies overweight from BMI 23, and obesity from 27.5, for people of South Asian, Chinese, other Asian, Middle Eastern, Black African or African-Caribbean background. Whether clinician-led weight management is right for you is a clinical decision. Our eligibility guide sets out the UK criteria and who is not suitable. ### What should you take to the appointment? Take the full result. A clinician can do more with the numbers than with "my cholesterol is high". - The result itself, with its units and the date, and any earlier results you have. - Every medicine and supplement you take. - Whether heart disease, stroke or diabetes runs in your family. - Whether you smoke, and your blood pressure if you know it. - What you have already tried, and what got in the way. Expect your answers to be checked. The General Pharmaceutical Council (GPhC), the pharmacy regulator in Great Britain, says a prescriber must not base decisions on a questionnaire alone. For weight management, your weight, height or BMI has to be verified another way: a video consultation, in person, your clinical records or your GP. ### How does HeMed fit in? In April 2026 the pharmacy regulator reported cases where weight-loss treatment was approved on a self-declared online questionnaire alone, and told prescribers to verify rather than rely on it. HeMed starts with a blood test. The blood test screens for four key areas linked to weight and metabolic health. Cardiovascular risk (total cholesterol, LDL, HDL, triglycerides and the cholesterol ratio), liver function (ALT, AST and GGT), diabetes risk (HbA1c) and thyroid function (TSH). 10 markers in all. A clinician reviews your results before anything is prescribed and builds your plan around your markers. You retest every 6 months to see what is changing. A blood test alone does not diagnose cardiovascular disease. For a full risk assessment, the free NHS Health Check (ages 40 to 74) and your GP are the route. HeMed does not diagnose or treat high cholesterol, prediabetes or type 2 diabetes. Where a result needs GP-level attention, that is a reason to speak to your GP. Your GP can arrange further tests. The Care Quality Commission (CQC) is the regulator of health and social care services in England. Clinical, consultation and prescribing services are provided by eMed, a CQC-registered provider. ### Frequently asked questions **Is one raised cholesterol result a diagnosis?** No: a single result is a measurement. A clinician reads it against your age, blood pressure, smoking and family history, usually through a risk score such as QRISK3. A good target depends on your age, your conditions and your overall risk. **What HbA1c level counts as prediabetes?** An HbA1c of 42 to 47 mmol/mol is non-diabetic hyperglycaemia, often called prediabetes. 48 mmol/mol or above is the cut-off for diagnosing diabetes, confirmed by a repeat test if you have no symptoms. **Do I need to fast before a cholesterol test?** Usually not. The NHS says you might be asked not to eat for up to 12 hours before the test. Most people do not need to fast. HEART UK gives separate triglyceride levels for fasting and non-fasting samples, so ask which applies to your sample. **Will I be given medicine for cholesterol straight away?** Not everyone is. The NHS says you can lower your cholesterol by eating healthily and getting more exercise, and that some people also need to take medicine. You might need medicine if your level has not gone down after changing your diet and lifestyle. The same applies if you are at high risk of a heart attack or stroke. Your GP makes that decision with you. **Can I be considered for clinician-led weight management with raised cholesterol or prediabetes?** You may be. Both are on the UK list of weight-related health conditions a prescriber may consider alongside BMI. Eligibility is always a clinical decision, made after a review of your history, your medicines and your results. **Is the NHS Health Check free, and who can have one?** Yes, it is free, and it takes about 20 to 30 minutes. It is for people in England aged 40 to 74 without a diagnosed heart, kidney, diabetes or blood pressure condition. Inherited high cholesterol or a prescribed cholesterol-lowering medicine also rule it out. Your GP or local council offers it every 5 years, and it includes a cholesterol test. **Does being a man change the picture?** Men are more likely to get cardiovascular disease than women. In England in 2024, 70% of men were overweight or living with obesity, against 62% of women. The checks are the same for everyone. The same survey found raised cholesterol slightly more common in women (50%) than in men (45%). HeMed provides clinician-led weight management. This page is general health information, not medical advice. Treatment is prescription-only and is prescribed only where a clinician decides it is suitable. If you are worried about symptoms, speak to your GP, or use NHS 111. Next step: see what the HeMed blood test measures. Sources (17) - NHS England Digital, Health Survey for England 2024, "Adults' health" (raised cholesterol 45% of men; HbA1c reflects average blood sugar over the previous two to three months). digital.nhs.uk. Accessed 22 October 2026. - NHS, "High cholesterol", page last reviewed 13 March 2026. nhs.uk/conditions/high-cholesterol. Accessed 22 October 2026. - NHS, "Cholesterol levels", page last reviewed 13 March 2026. nhs.uk/conditions/high-cholesterol/cholesterol-levels. Accessed 22 October 2026. - HEART UK, "Understanding your cholesterol test results". heartuk.org.uk. Accessed 22 October 2026. - Diabetes UK, "Prediabetes", content last reviewed 27 January 2026. diabetes.org.uk. Accessed 22 October 2026. - Diabetes UK, "Diagnostic criteria for diabetes" (clinical recommendations for professionals). diabetes.org.uk. Accessed 22 October 2026. - National Institute for Health and Care Excellence, NG238 "Cardiovascular disease: risk assessment and reduction, including lipid modification", recommendations 1.1.4 and 1.1.7 and the non-HDL cholesterol recommendations, published 14 December 2023. nice.org.uk/guidance/ng238. Accessed 22 October 2026. - ClinRisk, QRISK3 risk calculator and its input list, after Hippisley-Cox J, Coupland C, Brindle P. BMJ 2017;357:j2099. qrisk.org. Accessed 22 October 2026. - NHS, "Medicines for high cholesterol", page last reviewed 13 March 2026. nhs.uk/conditions/high-cholesterol/medicines-for-high-cholesterol. Accessed 22 October 2026. - NHS, "Getting tested for high cholesterol" (when to ask for a test; most people do not need to fast), page last reviewed 13 March 2026. nhs.uk/conditions/high-cholesterol/getting-tested. Accessed 22 October 2026. - NHS, "NHS Health Check", page last reviewed 14 August 2023. nhs.uk/tests-and-treatments/nhs-health-check. Accessed 22 October 2026. - NHS, "Cardiovascular disease", page last reviewed 12 January 2026. nhs.uk/conditions/cardiovascular-disease. Accessed 22 October 2026. - NHS England, "NHS Diabetes Prevention Programme (NHS DPP)". england.nhs.uk. Accessed 22 October 2026. - NHS England Digital, Health Survey for England 2024, "Adults' overweight and obesity". digital.nhs.uk. Accessed 22 October 2026. - National Institute for Health and Care Excellence, NG246 "Overweight and obesity management", recommendations 1.9.7, 1.9.8, 1.9.11, 1.9.15, 1.9.16 and 1.9.17, published 14 January 2025, last updated 8 January 2026. nice.org.uk/guidance/ng246. Accessed 22 October 2026. - Electronic Medicines Compendium, Summary of Product Characteristics for the second licensed weight-management medicine, section 4.1 Therapeutic indications (the weight-related comorbid conditions given as examples: hypertension, dyslipidaemia, obstructive sleep apnoea, cardiovascular disease, prediabetes and type 2 diabetes mellitus). medicines.org.uk. Accessed 22 October 2026. Cited for the comorbidity list only; the medicine is not named on this page by policy. - General Pharmaceutical Council, "Guidance for registered pharmacies providing pharmacy services at a distance, including on the internet", section 4.2, February 2025 (PDF). pharmacyregulation.org. Accessed 22 October 2026. Numbered markers in the page text link to these entries. Statistics describe populations, not any one person’s results. Levels, thresholds and NHS access rules are quoted from the cited documents as published on 22 October 2026, can change, and are not a HeMed assessment of any individual. --- This is the plain-text version of the article at https://www.hemed.com/blog/raised-cholesterol-or-blood-sugar-what-a-clinician-checks-first, generated from the page on 2026-10-22. It is for information only and is not medical advice. Whether any treatment is right for a person is a clinical decision. Statistics describe populations, not any one person's results.