If you've had a mini-stroke or a full stroke, lowering your 'bad' cholesterol really aggressively doesn't seem to raise your chances of getting diabetes — the numbers show only a small difference between groups.

What we've found so far suggests that for people who have had a stroke or transient ischemic attack (TIA), lowering LDL cholesterol below 70 mg/dL does not appear to meaningfully increase the risk of developing diabetes. The evidence we've reviewed leans against a significant link between very low LDL levels and higher diabetes risk in this group. We analyzed the available research and found 68.0 assertions supporting the idea that aggressive LDL lowering in stroke or TIA survivors does not lead to a clinically important rise in diabetes risk [1]. No studies or assertions in our review refuted this. The data show only a small difference in diabetes rates between those who lowered LDL very aggressively and those who did not, suggesting the effect — if any — is minimal [1]. Our current analysis focuses specifically on individuals with a history of stroke or TIA. We cannot say whether these findings apply to people without such a history, as the evidence we’ve reviewed does not address that group. Also, while the number of supporting assertions is high, we base our summary only on what has been reported in these claims — not on raw study data or unpublished results. We recognize that managing cholesterol after a stroke involves balancing multiple risks and benefits. The possibility of diabetes is one concern, but it must be considered alongside the well-known benefits of preventing future vascular events. What we’ve found so far does not indicate that diabetes risk should be a major barrier to aggressive LDL lowering in this population. Practical takeaway: If you’ve had a stroke or mini-stroke, lowering your bad cholesterol very deeply — below 70 mg/dL — doesn’t seem to meaningfully raise your chances of getting diabetes, based on what we’ve seen so far.