There are several physical signs of high cholesterol, including the fatty lumps mentioned hear, white circles around the pupil and lumps on tendons especially around hands & ankles. Have a look at heartuk.org.uk/fh-familial-... for a couple of pictures and more details.
I know what the symptoms look like - my dad had all of them, then died of a heart attack in his early 50's. This was back in the 1980's and he'd never had his cholesterol tested and was otherwise aparently healthy. If only they had had regular health checkups & statins (diet doesn't touch the levels of CH we have) back then - he may well have lived much longer. Several of his brothers and sisters also had the same symptoms and heart problems.
Some diabetics think that in order to manage properly they need the insulin but use it as an excuse to eat whatever they like and blame the diabetes for the weight gain. Many patients refuse to change their diet as they think that the weight loss will somehow make them more unwell, as if the unhealthy diet was not the cause of the diabetes in the first place.
I've seen many, many patients who refuse to change their diets but, later on, blame the advice given for their weight gain.
I now routinely record in the patients notes what their attitude towards a healthier lifestyle is and whether they are receptive to the idea that they are in full control. Many later try to lay blame on us, rather than accept that change takes effort ans we cannot do it for them.
Some only decide to change after recovery from a diabetic coma or a heart or angina attack.
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