diabetes and statins

[SimonP]

Interestingly, there was a paper recently looking at correlations between large differences between CGM-predicted HbA1c (whatever it's called) and measured HbA1c. Apparently larger differences correlates with a particular kind of heart damage.

I don't suppose you have a DOI?

Does anyone know how the glycation of haemoglobin is affected by glucose - is it a concentration or a time effect (or more likely a combo of both?) With this information it would presumably be possible to predict a more accurate HbA1c from CGM data.

Ah that’s interesting @Bruce Stephens

I have heard similar in a conference presentation which was looking into differences in diabetes complications risk between individuals with the same HbA1c result.

Similarly, do you recall where/when/who by chance?

Presumably those with more stable BG have better outcomes in general (sounds more plausible than the alternative anyway!) It would be interesting to see whether it's cumulative time above or simply total area above the curve which has the most effect (which links into my question about HbA1c above, assuming the damage mechanism is similar).

It would be interesting to see the numbers though, and specifically what HbA1c values these people had - if they were considering people at or around 50 mmol/mol, then that would indicate that even small perturbations are pretty deleterious, whereas if those being compared had HbA1c values in the 60s or 70s that gives much more room for manoeuvre/space for there to be different effects at play re time above vs area above the curve.

 

[Bruce Stephens]

I don't suppose you have a DOI?

Does anyone know how the glycation of haemoglobin is affected by glucose - is it a concentration or a time effect (or more likely a combo of both?) With this information it would presumably be possible to predict a more accurate HbA1c from CGM data.

Found it. It's open access.

Association between the GMI/HbA1c ratio and preclinical carotid atherosclerosis in type 1 diabetes: impact of the fast-glycator phenotype across age groups - Cardiovascular Diabetology

Background Since the arrival of continuous glucose monitoring (CGM), the relationship between the glucose management indicator (GMI) and HbA1c has been a topic of considerable interest in diabetes research. This study aims to explore the association between the GMI/HbA1c ratio and the presence...

cardiab.biomedcentral.com

 

[SimonP]

Found it. It's open access.

Association between the GMI/HbA1c ratio and preclinical carotid atherosclerosis in type 1 diabetes: impact of the fast-glycator phenotype across age groups - Cardiovascular Diabetology

Background Since the arrival of continuous glucose monitoring (CGM), the relationship between the glucose management indicator (GMI) and HbA1c has been a topic of considerable interest in diabetes research. This study aims to explore the association between the GMI/HbA1c ratio and the presence...

cardiab.biomedcentral.com

Thanks!

So from a quick scan, this isn't to do with glucose variability (area above the curve vs time above the curve, etc.) as I'd assumed, but rather to do with so called fast glycators. i.e. those for whom glycation happens more rapidly than the average/expected rate. Their metric for this is that GMI/HbA1c < 0.9, where GMI is HbA1c calculated from CGM data over a 14 day period, and HbA1c is a blood test.

Assuming stable/repeatable blood glucose (i.e. no instability close to the measurement window) over the ~3 month period which the blood test measures, I assume this would produce the "expected" GMI value (based on the CGM values alone), but a higher than expected HbA1C blood test value (due to the faster rate of glycation meaning more haemoglobin has been glycated.)

I think the question I have, which I couldn't easily find an answer for (I need to have a more in-depth read of the paper) is how similar/dissimilar the correlations between plaque formation and GMI/HbA1c vs plaque formation and plain HbA1c are.

Fig1A also looks slightly odd - the distribution of the difference between GMI and HbA1c - interesting that it has a dip in the middle of what otherwise looks like a normal distribution, which makes me wonder if this is a quantisation issue and they have done something weird with their band sizing (they look very small around the 0 mark, but consistently larger elsewhere) or whether there truly is some strange double tailed symmetry around 0 for some reason.

 

[Drummer]

Hi i have T2 diabetes, I have been on statins for 17 years, i read on the diabetes site that most people with diabetes is offered statins because living with diabetes increases the risk of heart attack and stroke, however i have since been told that statins do not help prevent heart attacks and strokes and statins can actually cause diabetes, cognitive problems , brain fog and muscle and joint problems. I was sent a link by a friend, it stated that statins was a silent killer. and some peoples stories were frightening , many people decided to stop taking the statins and said they don't prevent heart attacks and strokes as many of them had family members that had taken statins and still took heart attacks and strokes, many told stories of people they knew who got dementia, apparently the statins robs the body of the good cholesterol as well as the bad and the brain needs the good cholesterol to function. I have been suffering with really bad brain fog, my short term memory is getting worrying, i have been suffering terrible muscle/ joint pain. after reading peoples stories about statins im wondering if i should consider coming off them, but im really concerned it might be a massive mistake, I would be most grateful for any feedback and would love to know if any other type 2 diabetics are on statins and if they too have any of the problems i have mentioned. TIA

I had problems for several years after just 5 weeks of taking Atorvastatin.
I stopped taking them 8 years ago and it has been a real slog to regain the memories - probably false ones in many cases, but I relearned and forced myself to retain new things day after day. These days I do sometimes suddenly recall something from years ago quite spontaneously.
The last muscular ache departed after 18 months and I have been regaining strength since then,
As of now I have never felt better. but my brother in law insists that as the GP prescribed them he has to continue to take them and my sister mourns for the man he was, as he can no longer hold a conversation, no longer reads, sits and stares at the TV all day rather than being the active and watches the same film again and again as he doesn't remember seeing it before. He can no longer remember which turn off to take on a roundabout, my sister has to prompt him several times to get him to go down the right road.
If I am to die earlier than I might have, so be it. I am thankful to be here with all my faculties intact than staring at a wall in a care home with all those extra days to sit through.

 

[Leadinglights]

I had problems for several years after just 5 weeks of taking Atorvastatin.
I stopped taking them 8 years ago and it has been a real slog to regain the memories - probably false ones in many cases, but I relearned and forced myself to retain new things day after day. These days I do sometimes suddenly recall something from years ago quite spontaneously.
The last muscular ache departed after 18 months and I have been regaining strength since then,
As of now I have never felt better. but my brother in law insists that as the GP prescribed them he has to continue to take them and my sister mourns for the man he was, as he can no longer hold a conversation, no longer reads, sits and stares at the TV all day rather than being the active and watches the same film again and again as he doesn't remember seeing it before. He can no longer remember which turn off to take on a roundabout, my sister has to prompt him several times to get him to go down the right road.
If I am to die earlier than I might have, so be it. I am thankful to be here with all my faculties intact than staring at a wall in a care home with all those extra days to sit through.

Pity he doesn't forget to take the statins then. It doesn't sound as if he is particularly safe to drive, your sister should be worried about that.
Could she not have a word with the doctor.

 

[Drummer]

Pity he doesn't forget to take the statins then. It doesn't sound as if he is particularly safe to drive, your sister should be worried about that.
Could she not have a word with the doctor.

They no longer take their caravan for long trips, as they did in the past.
Their GP is very old school, she keeps hoping he'll retire or fall off the twig as he rules their local clinic completely with la main morte du passé.

 

[nonethewiser]

As of now I have never felt better. but my brother in law insists that as the GP prescribed them he has to continue to take them and my sister mourns for the man he was, as he can no longer hold a conversation, no longer reads, sits and stares at the TV all day rather than being the active and watches the same film again and again as he doesn't remember seeing it before. He can no longer remember which turn off to take on a roundabout, my sister has to prompt him several times to get him to go down the right road.

Your sister is very irresponsible allowing her husband to drive in that state, would he have the faculty to brake if a child ran out in front of his car?

DVLA should be notified of his poor health so to take his licence away as his not fit to drive, not being unkind by saying this as it's all our responsibility to keep our roads safe.

 

[Felinia]

Hi Felina, Thank you for your reply, I was put on statins back in 2008, at the time i had been ill and i had blood work done and they discovered at the time that my cholesterol was high and because my father had died of a heart attack at 60 they said i would be best to take simvastatin as a precaution and should take them for life. I have been on these statins until a few weeks ago and they changed me to Arivostatin 40mg. I was diagnosed with type 2 diabetes 3 years ago, i have never been on medication, im actually surprised as my last HB1Ac was 57

Hi Jane58
Your story is just like mine with statins and my dad. Actually it's becoming more common for people just into the diabetic range (below 60 at my GP) to be given the opportunity to lower their HbA1c with just lifestyle changes, as long as the level doesn't go up. I was initially successful with that approach, but then became ill (unrelated) and my level shot up to 88 and I was put on medication. Chipping away at it. I hope the new statin works out for you and your symptoms dissipate.

 

[jane58]

I had problems for several years after just 5 weeks of taking Atorvastatin.
I stopped taking them 8 years ago and it has been a real slog to regain the memories - probably false ones in many cases, but I relearned and forced myself to retain new things day after day. These days I do sometimes suddenly recall something from years ago quite spontaneously.
The last muscular ache departed after 18 months and I have been regaining strength since then,
As of now I have never felt better. but my brother in law insists that as the GP prescribed them he has to continue to take them and my sister mourns for the man he was, as he can no longer hold a conversation, no longer reads, sits and stares at the TV all day rather than being the active and watches the same film again and again as he doesn't remember seeing it before. He can no longer remember which turn off to take on a roundabout, my sister has to prompt him several times to get him to go down the right road.
If I am to die earlier than I might have, so be it. I am thankful to be here with all my faculties intact than staring at a wall in a care home with all those extra days to sit through.

 

[jane58]

Hi thank you for your reply, do you mind me asking what side effects you had? its Nearly 8 weeks i have taken Atorvastatin, started having headaches every day, unsure if the new statins are what is causing them.

 

[Leadinglights]

Hi thank you for your reply, do you mind me asking what side effects you had? its Nearly 8 weeks i have taken Atorvastatin, started having headaches every day, unsure if the new statins are what is causing them.

Quite possibly as they coincide with the new medication. Headaches can sometimes be caused by dehydration.
An easy test would be not to take for a few days and see if the headaches disappear. If not there may be another cause, your eyes for example or high blood pressure.

 

[helli]

its Nearly 8 weeks i have taken Atorvastatin, started having headaches every day, unsure if the new statins are what is causing them.

Have you read the leaflet that came with the tablets?
This will list the possible side effects and give you an idea whether the headaches are likely to be related.

I always read the leaflets that come with drugs so I can be aware of side effects and understand if there are any "limitations" such as not to take with alcohol or grapefruit or whether to take with food or not. Sometimes the doctor or pharmacist may explain this but not always. They don't always know everything about every drug they prescribe or dispense.
It is important for me to be informed and in control of my drugs and their side effects.

 

[jane58]

Have you read the leaflet that came with the tablets?
This will list the possible side effects and give you an idea whether the headaches are likely to be related.

I always read the leaflets that come with drugs so I can be aware of side effects and understand if there are any "limitations" such as not to take with alcohol or grapefruit or whether to take with food or not. Sometimes the doctor or pharmacist may explain this but not always. They don't always know everything about every drug they prescribe or dispense.
It is important for me to be informed and in control of my drugs and their side effects.

Hi I just read the label and yes headaches are listed as a side effect, I think i will have to make a appt with gp and see if he/she will change the statins

 

[jane58]

Hi I just read the label and yes headaches are listed as a side effect, I think i will have to make a appt with gp and see if he/she will change the statins

 

[Drummer]

Your sister is very irresponsible allowing her husband to drive in that state, would he have the faculty to brake if a child ran out in front of his car?

DVLA should be notified of his poor health so to take his licence away as his not fit to drive, not being unkind by saying this as it's all our responsibility to keep our roads safe.

Unfortunately my brother in law is in robust good health and has no reason to take statins other than his GP's opinion. He seems perfectly fit to drive, it is just that in the time between being told which turning is required - my sister has always done the navigation, and arriving at the roundabout the information is lost.
I had exactly the same problem as the statin affected my memory quite badly - brains are constructed from lipids the nervous system as a whole is protected by a myelin sheath - also lipid material, all things taught at secondary school, but once an opinion is widely accepted as truth there seems to be no changing it.

 

[nonethewiser]

Unfortunately my brother in law is in robust good health and has no reason to take statins other than his GP's opinion. He seems perfectly fit to drive, it is just that in the time between being told which turning is required - my sister has always done the navigation, and arriving at the roundabout the information is lost.

Are you sure he's in robust good health & safe to drive?

my sister mourns for the man he was, as he can no longer hold a conversation, no longer reads, sits and stares at the TV all day rather than being the active and watches the same film again and again as he doesn't remember seeing it before. He can no longer remember which turn off to take on a roundabout, my sister has to prompt him several times to get him to go down the right road.

To me he sounds in no fit state to drive but perhaps I'm wrong.

 

[Inka]

Far better that he be assessed than be on the road when he shouldn’t, Drummer. Cognitive problems can stop people driving, and it sounds like he has memory issues. Health isn’t just about being physically robust. Mental health counts too, and Cognitive Problems is one of the Health problems that needs reporting to the DVLA.

 

[Drummer]

Hi thank you for your reply, do you mind me asking what side effects you had? its Nearly 8 weeks i have taken Atorvastatin, started having headaches every day, unsure if the new statins are what is causing them.

I wasn't sure if you were asking me - but it hit me like a truck - I was walking with sticks after about 3 weeks taking Atorvastatin and Metformin, my hips knees and ankles were painful, my muscles ached, I became unable to recall a lot of things - I sing English Folk music and had to relearn all my songs - luckily I had made a start on writing them down for my daughter, but it took months of work to get them back enough to sing from the words. I had to stick a post it on the photograph on my dresser to remind me which one was my mother. I was burning dinner, forgetting to go shopping, I was unable to concentrate enough to knit.
On top of that Metformin made me explosively faecally incontinent, my insides knotted up really painfully.
My darkest moments were just before Christmas 2016 when I decided that it might be best to kill myself rather than lose my mind completely and end up like the people I had seen in the care home where I worked for a time. Around the solstice it suddenly hit me that every morning when the medication trolley went around, the noise and energy level in the sitting room dropped to almost nothing.
I threw the tablets in the bin. It was a long way back but I think that I managed it after some years.

 

[jane58]

I wasn't sure if you were asking me - but it hit me like a truck - I was walking with sticks after about 3 weeks taking Atorvastatin and Metformin, my hips knees and ankles were painful, my muscles ached, I became unable to recall a lot of things - I sing English Folk music and had to relearn all my songs - luckily I had made a start on writing them down for my daughter, but it took months of work to get them back enough to sing from the words. I had to stick a post it on the photograph on my dresser to remind me which one was my mother. I was burning dinner, forgetting to go shopping, I was unable to concentrate enough to knit.
On top of that Metformin made me explosively faecally incontinent, my insides knotted up really painfully.
My darkest moments were just before Christmas 2016 when I decided that it might be best to kill myself rather than lose my mind completely and end up like the people I had seen in the care home where I worked for a time. Around the solstice it suddenly hit me that every morning when the medication trolley went around, the noise and energy level in the sitting room dropped to almost nothing.
I threw the tablets in the bin. It was a long way back but I think that I managed it after some years.

 

[jane58]

Drummer i am so sorry to hear everything you went through, but glad you was able to turn things around after bining the meds, i have never been on metformin, i have heard of a few horror stories about them. I don't think id take them if offered. do you mind telling me how you got your diabetes into remission? My current Hb A1c is 57