Cholesterol questions

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EmmaL76

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Relationship to Diabetes
Type 1.5 LADA
Hi all, okay so my recent blood test were all good, hba1c 35, everything else perfect apart from cholesterol. When I was diagnosed my total cholesterol was 4.8 but all ratios out of range. 6 months later total 5.9 all ratios in range. Last test 5.4 for total all ratios optimal. All though I do low carb, my fat consumption is still not high. Splash of cream in morning tea, I do use full fat milk in my tea for the rest of the day, I don’t really eat much cheese and I eat the odd sausage and peanut butter a couple of times a week. I would consider my diet lowish fat and very low carb. My doctor has asked to talk to me about statins. I have heard lot of bad things about these and am anxious about unwanted side effects but equally worried about heart health although my resting heart rate is in the 50’s and I have very good blood pressure. So my questions are .
1. How many of you have had bad reactions to statins?
2. Is there a reason why my ratios are so good but my total is high?
3. What effect have people found with benecol etc?
4. Has anyone found that over time with my type of diet that their cholesterol came down eventually ?
5. Or should I just suck it up, stop being a big baby and take the darn things because doctor knows best?

Any advice, on any of my questions would really be appreciated. Thanks in advance xx
 
Also to add, I say all optimal for ratios, my HDL was slightly above recommended on checking. Could this be a problem ?
Side note, I’m also underweight so not easy to cut things out. Also don’t worry I won’t use any bodies personal experience to influence my own decision. It’s just an area that really confuses me xx
 
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EmmaL76 said:
Hi all, okay so my recent blood test were all good, hba1c 35, everything else perfect apart from cholesterol. When I was diagnosed my total cholesterol was 4.8 but all ratios out of range. 6 months later total 5.9 all ratios in range. Last test 5.4 for total all ratios optimal. All though I do low carb, my fat consumption is still not high. Splash of cream in morning tea, I do use full fat milk in my tea for the rest of the day, I don’t really eat much cheese and I eat the odd sausage and peanut butter a couple of times a week. I would consider my diet lowish fat and very low carb. My doctor has asked to talk to me about statins. I have heard lot of bad things about these and am anxious about unwanted side effects but equally worried about heart health although my resting heart rate is in the 50’s and I have very good blood pressure. So my questions are .
1. How many of you have had bad reactions to statins?
2. Is there a reason why my ratios are so good but my total is high?
3. What effect have people found with benecol etc?
4. Has anyone found that over time with my type of diet that their cholesterol came down eventually ?
5. Or should I just suck it up, stop being a big baby and take the darn things because doctor knows best?

Any advice, on any of my questions would really be appreciated. Thanks in advance xx
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Do the QRISK calculation for yourself.
qrisk.org/three/

As Eddie E keeps pointing out, ratios have fallen by the wayside, we're back to Total Chol minus HDL as the guideline plus a renewed emphasis on absolute level of LDL. LDL are the blighters that get through the pores in the artery walls and deposit Cholesterol causing the progression of foam cells, fatty streaks, atheroma, plaques, strokes, heart attacks, pad, TIAs etc
 
Burylancs said:
Do the QRISK calculation for yourself.
qrisk.org/three/

As Eddie E keeps pointing out, ratios have fallen by the wayside, we're back to Total Chol minus HDL as the guideline plus a renewed emphasis on absolute level of LDL. LDL are the blighters that get through the pores in the artery walls and deposit Cholesterol causing the progression of foam cells, fatty streaks, atheroma, plaques, strokes, heart attacks, pad, TIAs etc
Click to expand...
Ok thanks burylancs… deep breath. I’m going to do it
 
Ratios are fairly meaningless
If you get your numbers right, the ratios follow.
If all your cholesterol is high, the ratios can still look correct, even though all the individual numbers are elevated.
 
Thanks so Much for that. I have never heard of it, must of missed eddies posts. Although I don’t know my type the results were risk of 2 as a type 2 and 4 as a type 1.
 
Hi Emma we seem to have different reaction to statins, I would not take them ever again
I was on bezafibrate for a few years the Dr took me off them and I asked why and he laughed and said they are not working, so he put me on simvastatin first then atorvastatin and I had bad reactions to both in the muscles of my legs it took me quite a few weeks to get them back to normal thats my story, yet, my husband who takes the simvastatin
does not have any reactions whatsoever we all need the good cholesterol to some degree perhaps someone can
give their opinion but its just that, an opinion, not a recommendation you should not take them best wishes Iris
 
travellor said:
Ratios are fairly meaningless
If you get your numbers right, the ratios follow.
If all your cholesterol is high, the ratios can still look correct, even though all the individual numbers are elevated.
Click to expand...
See that’s what confused me, ratios are good total chol is high. Must be doing something wrong. Thanks traveller
 
EmmaL76 said:
See that’s what confused me, ratios are good total chol is high. Must be doing something wrong. Thanks traveller
Click to expand...
With just ratios, if you double all your numbers, even though your total cholesterol is 11.8, you'll still have the same ratios.
So even if your cholesterol is through the roof, ratios are "good".
I have never used them, I always use the individual numbers.
I also take statins.
 
RirisR said:
Hi Emma we seem to have different reaction to statins, I would not take them ever again
I was on bezafibrate for a few years the Dr took me off them and I asked why and he laughed and said they are not working, so he put me on simvastatin first then atorvastatin and I had bad reactions to both in the muscles of my legs it took me quite a few weeks to get them back to normal thats my story, yet, my husband who takes the simvastatin
does not have any reactions whatsoever we all need the good cholesterol to some degree perhaps someone can
give their opinion but its just that, an opinion, not a recommendation you should not take them best wishes Iris
Click to expand...
Thanks so much… seems like it’s a bit of a case of suck it and see ! Sorry they didn’t work out for you x
 
travellor said:
With just ratios, if you double all your numbers, even though your total cholesterol is 11.8, you'll still have the same ratios.
So even if your cholesterol is through the roof, ratios are "good".
I have never used them, I always use the individual numbers.
I also take statins.
Click to expand...
Right ok, I think I’m finally getting it. My individual numbers are all good accept pesky total. 😡 Sorry, I’m such a stress head
 
Burylancs said:
Good Luck ;-)

There is also an NHS page called 'Qrisk explained'
Click to expand...

@Burylancs A bit off-topic and I’ve probably missed a post explaining this but why does having Type 1 diabetes increase heart risk so much? I did the calculator twice - once as Type 1, which I am, and again having removed Type 1 and leaving everything else the same. The difference was shocking.

I’d heard about metabolic syndrome and Type 2 risk but not so much on Type 1. That’s probably me not reading around on the topic, but any information or links would be appreciated regarding exactly why the risk is so increased.

Apologies for hijacking your thread a bit @EmmaL76 I was offered statins but refused them. My ratio was good, my HDL high and my triglycerides very low. I personally think it’s always easier to make decisions with the full facts, so I hope my question above helps.
 
Inka said:
@Burylancs A bit off-topic and I’ve probably missed a post explaining this but why does having Type 1 diabetes increase heart risk so much? I did the calculator twice - once as Type 1, which I am, and again having removed Type 1 and leaving everything else the same. The difference was shocking.

I’d heard about metabolic syndrome and Type 2 risk but not so much on Type 1. That’s probably me not reading around on the topic, but any information or links would be appreciated regarding exactly why the risk is so increased.

Apologies for hijacking your thread a bit @EmmaL76 I was offered statins but refused them. My ratio was good, my HDL high and my triglycerides very low. I personally think it’s always easier to make decisions with the full facts, so I hope my question above helps.
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You know what inka, I thought exactly the same thing, I fully believed type 2 would be more risky ?? And hijack away… my threads are usually full of pointless flapping anyway !
 
Thanks @EmmaL76 I don’t think you flap at all. Personally I’d say it was completely normal to be concerned about cholesterol, heart risk and statins. It’s so hard to pick out the facts sometimes.

I forgot to say that my total cholesterol is above target so I’m in a similar position really. Mine’s usually around 5. My GP has just written that this is normal for me and all my numbers are good, but looking at that Risk Calculator, I think I’ll join you in a bit of understandable flapping! My heart age was below my actually age without Type 1 but above with it, and that’s made me rather grumpy - as if tedious Type 1 isn’t enough of a pain as it is!
 
Inka said:
I’d heard about metabolic syndrome and Type 2 risk but not so much on Type 1. That’s probably me not reading around on the topic, but any information or links would be appreciated regarding exactly why the risk is so increased.
Click to expand...

I asked about this when trying to understand my own QRISK score with my consultant.

They said it was connected to the almost inevitable increased glucose variability and instability with T1. Even with an ’on target‘ HbA1c that does a lot to mitigate risk, there will be glucose excursions that a non-D would never see, and impact on the CV system.

Plus the fact that sadly a relatively small proportion of T1s in the UK meet the suggested guideline for A1c and glucose targets. So for the calculator, the vast majority of people asking will not have (or consistently have had) any particular HbA1c.

Depending on how your T1 has behaved over the years this might be a limitation of QRISK estimates for you as an individual I suppose? But they seem to be refining and improving QRISK with each version.
 
Thanks, Mike. It freaked me out a bit, for sure. I just googled and found this, which I’d never heard of:

https://www.heart.org/en/news/2018/...-in-type-1-diabetes-may-lead-to-heart-disease

I’ve asked my consultant about heart risk and statins before and she’s just given what I thought was the usual speech about doing your best to keep good control, but actually maybe good control has more, and less obvious, benefits than we think?
 
OK so I had misremembered QRISK… An extra year on my age has just tickled me up over 10% so I suspect I’ll be encouraged to consider statins again at my next review.

Frustratingly there is absolutely no reference made to diabetes management other than that you ‘have it’. I had remembered that you added HbA1c alongside BP etc.

Which must mean that QRISK uses data from an ‘average’ T1, and the risks associated with that level of BG management?

If memory serves in 2015 only 6.5% of people with T1 in the UK achieved a target A1c of 48mmol/mol (it was when NICE were considering changing the A1c target from 7).

Perhaps this is why a consultant once said to me that QRISK doesn’t really work for T1s?
 
Thanks everybody for your input..
from todays experiment I have concluded that my risk is 3… meaning there is a 97% chance I will not pass away in the next 10 years. So I can get on with my day and you guys are stuck with me for at least a decade !
 
Phew! Let’s hope your consultant was right! I’ve just been reading a long article linking to various studies round the world and the general conclusions seemed to be that good control reduced risks and that having kidney complications was often associated with CVD risk in Type 1s. It’s a pity there’s not a Type 1 Risk calculator where we can add HbA1C. It must have some effect surely?
 
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