Routine prescribing of cholesterol-lowering drugs

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runner

runner

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Relationship to Diabetes
Type 1.5 LADA
HI,

My local surgery is routinely prescribing cholesterol-lowering medication for diabetics as a preventive measure. I have resisted so far because my control is fairly good, I don't have high blood pressure and when I asked for both levels of my cholesterol to be tested (good and bad) the ratio of good to bad was good. My cholesterol is about 5.2, which I'm told is not ideal.

Has anyone else come across this routine prescribing? I am still resisting, because I take enough medication as it is and don't want to take stuff if I don't need it.
 
Um!!....not sure on this. I will be having them as my Cho is 7, my good is bad, and my bad is good, so it all needs sorting. I don't think it is routine though.
 
When I was diagnosed last year I was put on 11 different medications. Prior to this I might have had four paracetomols a year, so I was very resistant to taking all these drugs. I had dreadful side-effects and it took me months to sort out the culprits. All the time I was trying to persuade my doctor to let me stop taking as many as possible. Now I'm on 5 drugs, due to come off two of them next month.

One of the drugs I take is simvastatin for cholesterol. My cholesterol was 2.4 last time around, 3.7 the time before that. I asked if I could stop them, since my cholesterol is clearly OK without them, although they are also clearly reducing the level. She said that the evidence was that they help even those with good cholesterol and that the preferred level for diabetics was below 4.0.

I'm now resigned to taking these drugs. It's no real hardship, and thankfully they no longer cause me side-effects, so I'll keep taking them. I think aspirin is another drug routinely prescribed, if you have had any incidence of heart problems, which I did when diagnosed.
 
Re: high cholseterol

Bad luck about the cholesterol, hope it gets sorted for you.
 
Hi Northener,

That is low! Guess I'll see how it goes...
 
runner said:
HI,

My local surgery is routinely prescribing cholesterol-lowering medication for diabetics as a preventive measure. I have resisted so far because my control is fairly good, I don't have high blood pressure and when I asked for both levels of my cholesterol to be tested (good and bad) the ratio of good to bad was good. My cholesterol is about 5.2, which I'm told is not ideal.

Has anyone else come across this routine prescribing? I am still resisting, because I take enough medication as it is and don't want to take stuff if I don't need it.
Click to expand...
The choice is yours as to whether you take the drugs or not. A Doctor can recomend but the final choice is yours. There's plenty of evidence to show that the side effects are not good and also that they only help a few people.

Northerner said:
When I was diagnosed last year I was put on 11 different medications. Prior to this I might have had four paracetomols a year, so I was very resistant to taking all these drugs. I had dreadful side-effects and it took me months to sort out the culprits. All the time I was trying to persuade my doctor to let me stop taking as many as possible. Now I'm on 5 drugs, due to come off two of them next month.
Again the choice is yours as to whether you want to take them. Do some research so that you are well informed regarding your condition

One of the drugs I take is simvastatin for cholesterol. My cholesterol was 2.4 last time around, 3.7 the time before that. I asked if I could stop them, since my cholesterol is clearly OK without them, although they are also clearly reducing the level. She said that the evidence was that they help even those with good cholesterol and that the preferred level for diabetics was below 4.0.
Your lovely Doctor gets a bonus in her pay packet for prescribing statins. She has a vested interest in you taking them.

I'm now resigned to taking these drugs. It's no real hardship, and thankfully they no longer cause me side-effects, so I'll keep taking them. I think aspirin is another drug routinely prescribed, if you have had any incidence of heart problems, which I did when diagnosed.
Click to expand...
Again Asprin has been proved not to be of any help unless you have had previous problems
I own up to being one of those who refuses to take any statins
 
runner said:
HI,

My local surgery is routinely prescribing cholesterol-lowering medication for diabetics as a preventive measure. I have resisted so far because my control is fairly good, I don't have high blood pressure and when I asked for both levels of my cholesterol to be tested (good and bad) the ratio of good to bad was good. My cholesterol is about 5.2, which I'm told is not ideal.

Has anyone else come across this routine prescribing? I am still resisting, because I take enough medication as it is and don't want to take stuff if I don't need it.
Click to expand...
Dear runner

The following information is taken from a study named Jupiter and financed and Supported by AstraZeneca, the makers of the statin Crestor. I make no claims and I do not offer any medical advice but I thought this might be of interest. I have refused to take statins and will continue to do so!

“Increased levels of the inflammatory biomarker high-sensitivity C-reactive protein (HsCRP) predict cardiovascular events. Since statins lower levels of high-sensitivity C-reactive protein as well as cholesterol, we hypothesized that people with elevated high-sensitivity C-reactive protein levels but without hyperlipidemia might benefit from statin treatment... Current treatment algorithms for the prevention of myocardial infarction, stroke, and death from cardiovascular causes recommend statin therapy for patients with established vascular disease, diabetes, and overt hyperlipidemia. However, half of all myocardial infarctions and strokes occur among apparently healthy men and women with levels of low-density lipoprotein (LDL) cholesterol that are below currently recommended thresholds for treatment.”

Given the forgoing, how can the level of LDL be relevant to CVD? Is it possible that the wheels are about to fall off the cholesterol bandwagon? It seems to me that:

1.Statins do work mainly for people who already have CVD and
2.They should be prescribed on the basis of elevated HsCRP

When a statin reduces cholesterol, it is, at the same time, reducing synthesis of CoQ10, dolichols, selenoproteins, Rho, glutathione and normal phosphorylation by a similar amount. This, I believe, is the cause of the thousands of side effect reports largely unknown to the medical community. It is also a precursor to Vitamin D (via the action of sunlight on the skin). Since 80% of our cholesterol is produced in our body, i.e. not from our diet, is it not possible that the level is that which the body has decided it needs!

Regards Dodger
 
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HelenM said:
I found this very visual article which describes some of the statistics from the study which led to routine prescribing. The author is a GP who is also an editor for one of the cochrane groups so has an good understanding of evidence based health care.
http://www.nntonline.net/ebm/newsletter/2003/06/diabetes_and_statins.asp
Click to expand...

Thanks Helen. I guess I am in the first group of smiley faces as when I had an angiogram they did find some evidence of 'furring' in one of my main arteries, but 'not flow-restricting'. Probably down to my 20 years as a smoker - I think I probably got off lightly! So, I could be one of the 9 yellow faces and am probably benefitting. Hope they don't find out in ten years that it causes your eyelids to fall off or something!🙄🙂
 
Type1_Sue said:
The choice is yours as to whether you take the drugs or not. A Doctor can recomend but the final choice is yours. There's plenty of evidence to show that the side effects are not good and also that they only help a few people.

Yes, I am one of those who always asks why and will consider the facts/options. I also discussed the decision with my specialst nurse at the time who was supportive of mny choice/decison not to take them at present.

Again Asprin has been proved not to be of any help unless you have had previous problems
I own up to being one of those who refuses to take any statins
Click to expand...

The GP may well benefit financially if Statins are taken routinely, however, I don't believe all GP's act with this as their main purpose. It is good to do some research and the internet is great - and can be misleading - for this. I guess you just have to evaluate the provenance of any information and the validity of any research results!

We are all being encourages to take a more active part in managing our conditions, so help with information prior to blanket policies and decisions would be good.
 
Hi,

C*5_Dodger said:
Dear runner

Given the forgoing, how can the level of LDL be relevant to CVD? Is it possible that the wheels are about to fall off the cholesterol bandwagon? It seems to me that:

1.Statins do work mainly for people who already have CVD and
2.They should be prescribed on the basis of elevated HsCRP

When a statin reduces cholesterol, it is, at the same time, reducing synthesis of CoQ10, dolichols, selenoproteins, Rho, glutathione and normal phosphorylation by a similar amount. This, I believe, is the cause of the thousands of side effect reports largely unknown to the medical community. It is also a precursor to Vitamin D (via the action of sunlight on the skin). Since 80% of our cholesterol is produced in our body, i.e. not from our diet, is it not possible that the level is that which the body has decided it needs!

Regards Dodger
Click to expand...

Thanks for the info Dodger. I'd heard about the effect on CoQ10, wasn't so much aware of the others. I think there is much still to be learnt about cholesterol production and use and the association with heart problems. I guess all we can do is make an informed choice and be responsible for our individual treatment.
 
HelenM said:
I found this very visual article which describes some of the statistics from the study which led to routine prescribing. The author is a GP who is also an editor for one of the cochrane groups so has an good understanding of evidence based health care.
http://www.nntonline.net/ebm/newsletter/2003/06/diabetes_and_statins.asp
Click to expand...
Hi Helen,

Interesting study - I believe I'm one of the green faces. I think it just goes to prove that diabetics and their treatment needs, need to be considered holistically.
 
runner said:
HI,

My local surgery is routinely prescribing cholesterol-lowering medication for diabetics as a preventive measure. I have resisted so far because my control is fairly good, I don't have high blood pressure and when I asked for both levels of my cholesterol to be tested (good and bad) the ratio of good to bad was good. My cholesterol is about 5.2, which I'm told is not ideal.

Has anyone else come across this routine prescribing? I am still resisting, because I take enough medication as it is and don't want to take stuff if I don't need it.
Click to expand...

Yea, my gp is of similar mind, wanted to put me on statins last year as "preventative" measure, even though all my cholesterol and lipid results were within specified ranges at the time. so i refused, i dont see the point taking extra medications that we dont really need. We take enough already. My gp spouted research etc. I spoke to my consultant who agreed with me that as long as im in range no need to go on statins, he wrote to my gp regarding this.

next visit to gp, he told me that when i am discharged to thier care it will be up to them what i go on, feel like piggy in the middle 😱

I do understand that as diabetic i am more at risk and chlosteral should be 4 or less, i know they also look at blood pressure, heart disease in family etc. All this considered it is still our individual choice at the end of the day.🙄
 
tracey w said:
Yea, my gp is of similar mind, wanted to put me on statins last year as "preventative" measure, even though all my cholesterol and lipid results were within specified ranges at the time. so i refused, i dont see the point taking extra medications that we dont really need. We take enough already. My gp spouted research etc. I spoke to my consultant who agreed with me that as long as im in range no need to go on statins, he wrote to my gp regarding this.

next visit to gp, he told me that when i am discharged to thier care it will be up to them what i go on, feel like piggy in the middle 😱

I do understand that as diabetic i am more at risk and chlosteral should be 4 or less, i know they also look at blood pressure, heart disease in family etc. All this considered it is still our individual choice at the end of the day.🙄
Click to expand...

It most definately is, and it doesn't help when you are bing told different things by defferent medical professionals. I think your GP could be challenged if he chose to override a consultant's (presumabely diabetes specialist) advice. Your GP should be working with, not dictating to you. Perhaps you could show him the research Helen below has given a link to, and ask him to provide you with the evidence he bases his views on?

Alternatively, you could ask to remain under the care of the hospital team (specialsit diabetic nurse?) good luck!
 
runner said:
It most definately is, and it doesn't help when you are bing told different things by defferent medical professionals. I think your GP could be challenged if he chose to override a consultant's (presumabely diabetes specialist) advice. Your GP should be working with, not dictating to you. Perhaps you could show him the research Helen below has given a link to, and ask him to provide you with the evidence he bases his views on?

Alternatively, you could ask to remain under the care of the hospital team (specialsit diabetic nurse?) good luck!
Click to expand...

well, i should be getting my pump soon, so hopefully i will remain under the hospital! Unfortunately there are many people who just take what their gp prescribes as they think they know best! But thats the point they are general and not specialists!!!
 
Re pump

tracey w said:
well, i should be getting my pump soon, so hopefully i will remain under the hospital! Unfortunately there are many people who just take what their gp prescribes as they think they know best! But thats the point they are general and not specialists!!!
Click to expand...

Good luck with the pump - I'd be interested to know how you get on with it. 🙂
 
i take neither cho lowering drugs or statins as i have a very good cho level and have had noproblems with my heart. if you feel it is not gonna be beneficial to you dont take them as sue said it is your choice. my cho is always around the 3 mark and has been since i got diagnosed. i find that educating people on what is good for them to eat and how often is far more beneficial to them than ramming drugs down their necks all the time.
 
My doctors have tried to put me on statins too. I refused. I don't agree with medicating people who are not ill. My stepdad took statins for a while but had terrible memory problems which started when he started taking them and vanished as soon as he stopped. I don't like the fact that you cannot eat certain fruits when on statins - doctors are always on at us to eat more fruit and veg and I happen to like grapefruit, so I don't want to take a med and have to stop eating them.

I am quite cynical and don't like having meds shoved at me. I think GP practices get some kind of bonus if they put more people on these things, the drug companies send them on courses and expensive lunches and hand out freebies - look around any GP's office and you will see calendars, pens, post-its, all with drug company branding on.
 
As a side issue here. I was told that if you have Diabetes, all Precriptions are free,as I have a Hyatis hernia, I thought great. Now it transpires, that precriptions are only free, if you are prescribed any drugs for being Diabetic. IF, and this is what I am led to believe.....IF you go the diet and exercise route, you are not entitled to free scripts.

True!!!!.........or not True???
 
DiabeticDave said:
As a side issue here. I was told that if you have Diabetes, all Precriptions are free,as I have a Hyatis hernia, I thought great. Now it transpires, that precriptions are only free, if you are prescribed any drugs for being Diabetic. IF, and this is what I am led to believe.....IF you go the diet and exercise route, you are not entitled to free scripts.

True!!!!.........or not True???
Click to expand...

totally true dave, due to the fact as a diet controlled diabetic you dont need regular medication so its not financially viable to give you the exemption card
 
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