My statin dose has been increased

[Carina1962]

I am a Type 2 diabetic (diagnosed October 2009) and when i was diagnosed at a fasting glucose of 7.8, i was also found to have a high cholesterol of 9.4 so the GP immediately put me on Simvastin at 20mg. Last week i had my first diabetic review and even though my cholesterol had dropped down to 5.7the GP decided to double my dose to 40mg and then has ordered a liver function test in 6 weeks time. What i would like to know is if i continue to lose weight (i have already lost a stone and half) will i be able to reduce my statin dose back to 20mg or is it a case of once you are on the statins you have to stay on them? i have heard that most of the time they are for life because once the dose is reduced or stopped altogether then the cholestrol rises again and i suppose because i am diabetic i think the doctors like it to be as low as possible

 

[Northerner]

Hi Carina, I think the standard dose for statins is 40mg, so most people start on 20 then move fairly quickly up to 40mg so don't think of it as being on double the dose, you've just been increased to the standard dose - that's what happened to me anyway. Hard to tell whether you will need them for life. My chol was just over 4 when I was put on them and it went down to 2.4 after about 6 months so I decided to stop them. Haven't been tested since stopping them so don't know but expect it has increased, but hopefully still reasonable.

Your case is different as your chol was pretty high, whereas mine was getting very low.

 

[LisaLQ]

I wouldn't worry. My cholesterol was 5.7, and I've been on 40mg a day from the start.

 

[Peter C]

I am a Type 2 diabetic (diagnosed October 2009) and when i was diagnosed at a fasting glucose of 7.8, i was also found to have a high cholesterol of 9.4 so the GP immediately put me on Simvastin at 20mg. Last week i had my first diabetic review and even though my cholesterol had dropped down to 5.7the GP decided to double my dose to 40mg and then has ordered a liver function test in 6 weeks time. What i would like to know is if i continue to lose weight (i have already lost a stone and half) will i be able to reduce my statin dose back to 20mg or is it a case of once you are on the statins you have to stay on them? i have heard that most of the time they are for life because once the dose is reduced or stopped altogether then the cholestrol rises again and i suppose because i am diabetic i think the doctors like it to be as low as possible

I am a Type 2 diabetic (diagnosed October 2009) and when i was diagnosed at a fasting glucose of 7.8, i was also found to have a high cholesterol of 9.4 so the GP immediately put me on Simvastin at 20mg. Last week i had my first diabetic review and even though my cholesterol had dropped down to 5.7the GP decided to double my dose to 40mg and then has ordered a liver function test in 6 weeks time. What i would like to know is if i continue to lose weight (i have already lost a stone and half) will i be able to reduce my statin dose back to 20mg or is it a case of once you are on the statins you have to stay on them? i have heard that most of the time they are for life because once the dose is reduced or stopped altogether then the cholestrol rises again and i suppose because i am diabetic i think the doctors like it to be as low as possible

Hi Carina,
Type 2 Diabetes and Cholesterol problems go together like a horse and carriage. Most T2s are allegedly suffering from the Metabolic Syndrome ( formerly Syndrome X, Reavons Syndrome etc ). The Metabolic Syndrome is a nexus of conditions that usually occur together or in sequence after each other - visceral adiposity ( fat round the abdomen), T2 Diabetes, dyslipidemia( raised Cholesterol), and hypertension( raised blood pressure). All 4 are thought to be the manifestations/symptoms of a deeper underlying cause, perhaps Insulin Resistance. So anybody dxed with T2 is likely heir to raised chols and hypertension thereafter.
Despite the fact the Metabolic Syndrome is an unproven hypothesis it has received considerable attention over the last decade or so. In America they take it very seriously and have been trying to dx people with the Metabolic Syndrome. Last year the medical authorities issued advice to US Docs to forget the Metabolic Syndrome and stop worrying whether patients had it or not. They were advised to just treat each manifestation of the alleged Syndrome ( visceral adiposity, T2 diabetes, dyslipidemia and hypertension) as serious conditions in their own right, wade in and beat the crap out of each one as it occured.
But all 4 of the conditions when present interact with and exacerbate each other. Diabetes ( in both T1 and T2) has adverse effects on chols giving rise to the condition of Diabetic Dyslipidemia ( raised total chols, raised Trigs, raised LDL and lowered HDL ). So chols are a double whammy for T2 diabetics ; not only is dyslipidemia likely to come as part of the deal with T2 diabetes ( because of the Metabolic Syndrome) but also the diabetes is going to worsen the problem. On top of that Diabetes not only rasies LDL ("bad cholesterol") it spefically tends to raise the worse form of LDL which is called LDL-Pattern B (bad "bad cholestrol"). These are small particles of LDL wrapped round a bundle of cholesterol. They are the ones who are most effective at getting into the endothelium ( the space between the first and second layers of the artery walls) and depositing chols in plaques and atheromas( the cause of heart disease).
So, all in all, the relationship between chols and T2 diabetes are a major issue.
Get the numbers down by statins and get the distribution of LDL and HDL right. Once in a safe range you can review the situation and perhaps give diet a go to keep chols in line. But statins are a very effective bullet and generally safe ( with very few of the much vaunted side-effects affecting people). Basically as a T2 diabetic you've got lipid/cholesterol issues for the duration.
40mg of Simvastatin seems to be the NHS norm now, it was demonstrated by research to be the optimal dose as compared to other statins e.g. Lipitor.
And of course the usual answer also applies - Good Control of the diabetes.

 

[Carina1962]

Thanks all for your replies. It's funny but i've had high cholesterol for a number of years but was never put on statins until recently so maybe i was 'pre-diabetic' along with the high cholesterol without knowing it until i was diagnosed last October and didn't realise that high chol and T2 go together. It's really good to be able to share concerns on here as so many people know what each one is going through.

 

[Caroline Wilson]

I have heard of a few people (but only a very few) who have reduced their cholesterole and so had their statins reduced. You'd need to talk to your doctor and maybe referred to a dietician to help this happen.

Any medical worries you have, talk to your doctor or nurse and they will be able to help.

 

[cazscot]

Hi Carina,
Type 2 Diabetes and Cholesterol problems go together like a horse and carriage. Most T2s are allegedly suffering from the Metabolic Syndrome ( formerly Syndrome X, Reavons Syndrome etc ). The Metabolic Syndrome is a nexus of conditions that usually occur together or in sequence after each other - visceral adiposity ( fat round the abdomen), T2 Diabetes, dyslipidemia( raised Cholesterol), and hypertension( raised blood pressure). All 4 are thought to be the manifestations/symptoms of a deeper underlying cause, perhaps Insulin Resistance. So anybody dxed with T2 is likely heir to raised chols and hypertension thereafter.
Despite the fact the Metabolic Syndrome is an unproven hypothesis it has received considerable attention over the last decade or so. In America they take it very seriously and have been trying to dx people with the Metabolic Syndrome. Last year the medical authorities issued advice to US Docs to forget the Metabolic Syndrome and stop worrying whether patients had it or not. They were advised to just treat each manifestation of the alleged Syndrome ( visceral adiposity, T2 diabetes, dyslipidemia and hypertension) as serious conditions in their own right, wade in and beat the crap out of each one as it occured.
But all 4 of the conditions when present interact with and exacerbate each other. Diabetes ( in both T1 and T2) has adverse effects on chols giving rise to the condition of Diabetic Dyslipidemia ( raised total chols, raised Trigs, raised LDL and lowered HDL ). So chols are a double whammy for T2 diabetics ; not only is dyslipidemia likely to come as part of the deal with T2 diabetes ( because of the Metabolic Syndrome) but also the diabetes is going to worsen the problem. On top of that Diabetes not only rasies LDL ("bad cholesterol") it spefically tends to raise the worse form of LDL which is called LDL-Pattern B (bad "bad cholestrol"). These are small particles of LDL wrapped round a bundle of cholesterol. They are the ones who are most effective at getting into the endothelium ( the space between the first and second layers of the artery walls) and depositing chols in plaques and atheromas( the cause of heart disease).
So, all in all, the relationship between chols and T2 diabetes are a major issue.
Get the numbers down by statins and get the distribution of LDL and HDL right. Once in a safe range you can review the situation and perhaps give diet a go to keep chols in line. But statins are a very effective bullet and generally safe ( with very few of the much vaunted side-effects affecting people). Basically as a T2 diabetic you've got lipid/cholesterol issues for the duration.
40mg of Simvastatin seems to be the NHS norm now, it was demonstrated by research to be the optimal dose as compared to other statins e.g. Lipitor.
And of course the usual answer also applies - Good Control of the diabetes.

Thanks for this Peter, my hubby (who has been Type 2 for approx 9 years) has high bp, high cholesterol (but normal distribuition of body weight and a bmi of 23/24). And has been on bp tables, and statins from the start. I didnt realise it could all been interconnected.