HbA1c nice and low (fab) but cholesterol gone up (poop)

[Deb_l]

I had my six monthly review on Wednesday and my diabetes nurse gave in one hand and took away in the other!

Now for the good news - HbA1c is 35. Hurrah, says I. That's really good, especially as we have had Christmas in between.

Then she says - your cholesterol is slightly raised from last time. Oh poop, I was hoping that had come down as well, not up. We had a lengthy chat about statins and the alternatives and I have still resisted for now but I don't want to get too complacent as I definitely have a family history of cardiovascular issues to worry about.

The low carb, full fat approach to eating is REALLY working for me but I can only assume it's the full fat elements in my diet that have contributed to the higher cholesterol. The only full fat stuff I have is yogurt (lots of), cream (single cream and not a massive amount) and nuts (I've cut down on these recently). Is that really enough to have made the difference?

Figures for those that like them. Would you be worried about these? I think I will review again in six months and if they have gone up yet again, will have to seriously consider my diet choices or meds

 

[Dave_Z1a]

I am no expert but that doesn't look alarming to me. I would wager the fantastic Hb results are worth it!

 

[everydayupsanddowns]

Congratulations on your low HbA1c @Deb_l

With your family history, and a QRISK approaching 15% in your shoes I think I’d be tempted to try a low dose statin - you could get the common reduction in plaque-forming parts of your blood fats, the plaque stabilising aspect of anything that may have built up already, and (chances are) minimal, if any, side effects. Plus you’d be able to maintain your current menu with your lipids in the recommended range.

Perhaps worth giving a try for 6-12 months and see how you get on? That’s what I did when my QRISK went above 10%, and it helped enormously.

 

[Kopiert]

Congratulations on your amazing HbA1C results.

I am/was in a similar situation as you. My HbA1c was reasonable - on the pre-diabetic cusp but they were not concerned. I was also controlling by diet alone (although I was slipping!!).

But my cholesterol had steadily increased. It was the rate of increase they were most concerned with. MyQRISK figure got to about 20% when they started getting really insistent to take a statin. They had put a lot of pressure on me to take statins over a couple of years, and at this point, I gave in - it seemed the only sensible thing to do.

I am convinced that the stains have increased my BG levels dramatically. It is the only significant change I have made that would double my HbA1c in a few months. I had a conversation with the DN, who admitted the NHS puts cholesterol above blood sugar. They will want to deal with your heart before your diabetes (for a T2).

To counteract the blood sugar rise, I have gone from zero drugs to 4 metformin and now canagliflozin.

Your reaction to statins may be very different to mine - I know lots of people take a statin with no ill effect whatsoever. What annoyed me the most was the practice pharmacist said she had never heard of a statin causing a rise in blood sugar and she made me feel like an anti-vaxxer or something. Yet on the info sheet in the drug box is this: the number two warning of common side effects of Atorvastatin has raised blood sugar levels, particularly for diabetics.

Like you, I have a history of heart issues in my family; my cholesterol was getting high and has now reduced. But it has come at a cost. However, I agree with @everydayupsanddowns and try them, to see how you get on.

 

[Lynne888]

You’ve done brilliantly Deb, I’m sure you’re delighted. The nurse said cholesterol ‘slightly’ increased so maybe not major at this point? I’d wait and see what the next blood test reveals and see what happens then.

 

[Sharron1]

Congratulations on your low HbA1c @Deb_l

With your family history, and a QRISK approaching 15% in your shoes I think I’d be tempted to try a low dose statin - you could get the common reduction in plaque-forming parts of your blood fats, the plaque stabilising aspect of anything that may have built up already, and no side effects. Plus you’d be able to maintain your current menu with your lipids in the recommended range.

Perhaps worth giving a try for 6-12 months and see how you get on? That’s what I did when my QRISK went above 10%, and it helped enormously.

I decided to give Statins a try and see what happens. Am due a blood test in March which will be 4 months worth of it and I await the result with interest. My total Cholestrol is 6. 4 and my QRISK thing was 8%. The QRISK number in my opinion is calculated on the basis of using a sledge hammer to crack a minute peanut with wide generalisations. I am not aware that I suffered with any side effects from the Statin. For more info on Statins (as my surgery was so unhelpful) I contacted Heart Uk with my questions and they were very helpful.

Congrats on on the Hba1c, very pleasing.

 

[Deb_l]

I decided to give Statins a try and see what happens. Am due a blood test in March which will be 4 months worth of it and I await the result with interest. My total Cholestrol is 6. 4 and my QRISK thing was 8%. The QRISK number in my opinion is calculated on the basis of using a sledge hammer to crack a minute peanut with wide generalisations. I am not aware that I suffered with any side effects from the Statin. For more info on Statins (as my surgery was so unhelpful) I contacted Heart Uk with my questions and they were very helpful.

Congrats on on the Hba1c, very pleasing.

Yes, I suspect my QRISK is so high mainly because of family history. My dad died very young from a heart attack. Thank you for the Heart UK recommendation. I shall certainly look them up.

 

[Burylancs]

I had my six monthly review on Wednesday and my diabetes nurse gave in one hand and took away in the other!

Now for the good news - HbA1c is 35. Hurrah, says I. That's really good, especially as we have had Christmas in between.

Then she says - your cholesterol is slightly raised from last time. Oh poop, I was hoping that had come down as well, not up. We had a lengthy chat about statins and the alternatives and I have still resisted for now but I don't want to get too complacent as I definitely have a family history of cardiovascular issues to worry about.

The low carb, full fat approach to eating is REALLY working for me but I can only assume it's the full fat elements in my diet that have contributed to the higher cholesterol. The only full fat stuff I have is yogurt (lots of), cream (single cream and not a massive amount) and nuts (I've cut down on these recently). Is that really enough to have made the difference?

Figures for those that like them. Would you be worried about these? I think I will review again in six months and if they have gone up yet again, will have to seriously consider my diet choices or meds

View attachment 29003

Good progress apart from the 30% increase in LDL ( 'bad cholesterol'). One of the dangers traditionally associated with Low Carb/ high fat diets.

And how is your Thyroid bearing up under the low carb regime, have you had tests for that ? It's another problem traditionally associated with low carbing because the Thyroid needs plenty of glucose to transform T3 into T2.

Have you agreed a target HbA1c with your med team ? NICE recommends that the target HbA1c should reflect the individual's age, stage, other Health issues and duration of diabetes. We're advised by other sources not to just assume that 'lowest is best'.

 

[Drummer]

If you are losing weight cholesterol is part of the fat moving system so it might increase and remain at that number until it is no longer required.
Cholesterol acts as the tractor unit transferring a cargo of fat from cell to liver where it will be broken down, so it is only natural for more to be made during periods of weightloss.

 

[nonethewiser]

Yes, I suspect my QRISK is so high mainly because of family history. My dad died very young from a heart attack. Thank you for the Heart UK recommendation. I shall certainly look them up.

Given family history of CVD it makes sense to try a low dose statin to start off with, in your position that's what I would do anyway.

 

[everydayupsanddowns]

Yes, I suspect my QRISK is so high mainly because of family history. My dad died very young from a heart attack. Thank you for the Heart UK recommendation. I shall certainly look them up.

Let us know how you get on @Deb_l

I do understand your reluctance. I dithered for years, but it was my ‘qrisk creep‘ that made me think “why not”.

I’ve had no ill effects at all, and I wish I’d started on them years earlier!

 

[bujanin]

I’ve had no ill effects at all, and I wish I’d started on them years earlier!

Statins have been around for such a long time now. If there is one type that doesn't work for you because of indigestion or nausea there's another type that you can be prescribed but overall there's no reason to fear statins. Although they got a bad rep in the early days there are now wide held thoughts that they are so helpful everyone should be taking one. Even just for the anti-inflammatory benefits because that's what they are essentially, an anti-inflammatory.

I resisted for ten years not really knowing why.

Could I ask why do you resist Deb-I?

 

[Dragonheart]

Amazing hba1c result. Well done. And that alone may give you a little wriggle room on diet if you want to try that. Just be careful to avoid any slippery slopes.

So your triglcerides have increased as has your HDL. Which are both great news. And they will raise the total but in a good way!

The LDL is also slightly increased but that is totally normal whilst actively losing weight and hardly high.

I’d wait and see on the next test what direction things move in and personally would not take statins on the basis of those numbers alone right now.

My postcode shoves my qrisk up. If I lived a few hundred meters another direction it would be lower. It also doesn’t take account of how well managed my diabetes is and how and that has to matter. Someone above mentioned it’s a sledgehammer. It might be great at population level and a useful initial screening tool but the assumptions are huge and you really need to dig deeper into your personal situation than this does. Everyone has their own level of acceptable risk and decisions to make about which risks to take as no choice is risk free. Personally I know diabetes is a risk to me so that’s my priority. I’m not at all convinced cholesterol is an issue in the way widely prescribed right now, especially as the expert opinions are changing and vary so much. What we believed a few decades ago in quite a number of medical situations has since been disproved. Cholesterol/cvd issues may turn out to be another in a few more decades.

 

[DiabloT2]

After going low carb I saw a bit of an increase in cholesterol level but then a few months later a bit lower. I've found it does move around a bit. I discovered though that the same was true for years gone by before I was diagnosed as a diabetic. My choice has been to keep a watch. It continues to vary slightly in a similar range to yours, but I do not have a family history of CVD.

 

[Deb_l]

Statins have been around for such a long time now. If there is one type that doesn't work for you because of indigestion or nausea there's another type that you can be prescribed but overall there's no reason to fear statins. Although they got a bad rep in the early days there are now wide held thoughts that they are so helpful everyone should be taking one. Even just for the anti-inflammatory benefits because that's what they are essentially, an anti-inflammatory.

I resisted for ten years not really knowing why.

Could I ask why do you resist Deb-I?

I only resist because I already seem to be taking so many tablets and I’m only 54! I know that’s not a reason but I joke with my mum that I will be needing a nomad box like her soon.

I’m just ever so slightly annoyed at this result more than anything. I’ve lost seven stone this year, cut out all processed food, fast food and I’m eating as healthy as I’ve ever done in my life but still my cholesterol has gone up

I think my plan is to wait for the next 6 month review and if it has gone up again, give statins a try.

 

[Deb_l]

After going low carb I saw a bit of an increase in cholesterol level but then a few months later a bit lower. I've found it does move around a bit. I discovered though that the same was true for years gone by before I was diagnosed as a diabetic. My choice has been to keep a watch. It continues to vary slightly in a similar range to yours, but I do not have a family history of CVD.

Yes, a friend mentioned to me just yesterday that it could potentially be the weight loss and diet change that has shuffled my cholesterol levels. I’m not going to rush to change anything yet. My levels are not massively high so I’m going to leave it another six months and see what happens at the next test.

 

[Deb_l]

If you are losing weight cholesterol is part of the fat moving system so it might increase and remain at that number until it is no longer required.
Cholesterol acts as the tractor unit transferring a cargo of fat from cell to liver where it will be broken down, so it is only natural for more to be made during periods of weightloss.

I so LOVE this forum!! You learn so much every day and not just about diabetes

My weight has plateaued now and I don’t intend to lose any more, despite not being quite the perfect weight, if the BMI scale were to be believed. Hopefully my cholesterol will now start to settle down.

 

[Jules S]

I had my six monthly review on Wednesday and my diabetes nurse gave in one hand and took away in the other!

Now for the good news - HbA1c is 35. Hurrah, says I. That's really good, especially as we have had Christmas in between.

Then she says - your cholesterol is slightly raised from last time. Oh poop, I was hoping that had come down as well, not up. We had a lengthy chat about statins and the alternatives and I have still resisted for now but I don't want to get too complacent as I definitely have a family history of cardiovascular issues to worry about.

The low carb, full fat approach to eating is REALLY working for me but I can only assume it's the full fat elements in my diet that have contributed to the higher cholesterol. The only full fat stuff I have is yogurt (lots of), cream (single cream and not a massive amount) and nuts (I've cut down on these recently). Is that really enough to have made the difference?

Figures for those that like them. Would you be worried about these? I think I will review again in six months and if they have gone up yet again, will have to seriously consider my diet choices or meds

View attachment 29003

Google dr Paul Mason and listen to some of his talks about statins on utube. It may surprise you what he says. Obviously down to you as to what you make of it, I found it interesting.