Statin - starting dose

[Standup]

I've just had a go and came out at 14% which seems high for someone only recently diabetic and relatively fit etc. I think I'm with Helli on this one in that it feels quite a blunt tool bit like BMI . Does it assume that you're not managing your diabetes or does it take a 70% TIR as the baseline? My last two hospital consults I've been told very bluntly that I will get complications and I did wonder if that was true, based on old data or just an assumption that most people won't manage their condition that well? My numbers are much better than friends with type 2 who take a more relaxed approach but again no idea what that actually means? Is type 1 (as no box for type 3) inherently much worse?

 

[helli]

Is type 1 (as no box for type 3) inherently much worse?

Or is it assumed we have it for longer based on the myth that it is only diagnosed as a child?
I was surprised that the impact on QRISK3 is higher if you select Type 1 than if you select type 2 and this was the only explanation I could come up with.
It feels to me (as someone with no medical training) that the potential risk is higher for type 2 because you can have it for longer without any diagnosis and, hence, no treatment. But what do I know? I am just speculating which I know I shouldn't.

 

[Wendal]

Or is it assumed we have it for longer based on the myth that it is only diagnosed as a child?
I was surprised that the impact on QRISK3 is higher if you select Type 1 than if you select type 2 and this was the only explanation I could come up with.
It feels to me (as someone with no medical training) that the potential risk is higher for type 2 because you can have it for longer without any diagnosis and, hence, no treatment. But what do I know? I am just speculating which I know I shouldn't.

Morning All.It will be based on very general statistics like whether you have any of the risk factors so whether you are diabetic/ have smoked/ high cholesterol/high BMI etc.
So it will not take into account length of condition/ levels of control or measurement etc as you will either not have enough patients to fully validate it or much more likely they keep it simple so that it can have a very basic and general acceptance and suggest preventative treatment guidelines for the general patient population.

 

[grovesy]

Morning All.It will be based on very general statistics like whether you have any of the risk factors so whether you are diabetic/ have smoked/ high cholesterol/high BMI etc.
So it will not take into account length of condition/ levels of control or measurement etc as you will either not have enough patients to fully validate it or much more likely they keep it simple so that it can have a very basic and general acceptance and suggest preventative treatment guidelines for the general patient population.

I have not long come off the phone from the Practice Nurse, the recommendations are also now if you are over 70 to be prescribed regardless conditions as prevention.
Although conversation about Cholesterol, was informative, as I can't take Statins, she could not discuss the alternatives, she has to refer back to a Doctor.

 

[helli]

Morning All.It will be based on very general statistics like whether you have any of the risk factors so whether you are diabetic/ have smoked/ high cholesterol/high BMI etc.
So it will not take into account length of condition/ levels of control or measurement etc as you will either not have enough patients to fully validate it or much more likely they keep it simple so that it can have a very basic and general acceptance and suggest preventative treatment guidelines for the general patient population.

For reference, this is a QRISK3 calculator so you can how it is calculated and what is taken into consideration: https://qrisk.org/

But my wonderings were about how they came up with the figures. What do they consider to be a "typical/average person with Type 1 (or type 2) diabetes"?
I assume it is based on historical data but has it been "adjusted" to take into consideration the massive advancements in diabetes management that will not be included in that history?

 

[AndBreathe]

QRisk is useless in my view.

If I state non-diabetic, my score is 8.5% (against an average healthy bod at 10%). If I declare my single diabetic level A1c, leading to a T2 diagnosis, my score almost doubles to 15.2%. In both instances, my BMI of 18.7 is discounted, as it is outside the calculator's range, and I am "awarded" a BMI of 20.

All in all, it'd probably be as useful as licking my finger and lifting it to the wind.

Of course, GPs do what their guidance tells them to, but when their justification is that "everyone in the US takes them, and my wife would take them if I told her to", it doesn't fill one with confidence.

Two good things about that last sentence. Firstly, that GP has retired, and secondly, we moved surgery to be a bit closer to home, when patient/GP ratios at the old place just got silly.

AB - contentedly statin-free, but respects those who do their own research and reach whatever decision they choose.

 

[Deb_l]

I was started on 10mg atorvastatin and not had any side effects. I've not been on them long so don't know how effective they have been yet. My cholesterol isn't massively high but had continued to creep up and I have a pretty rubbish family history of heart disease and vascular issues.

 

[Inka]

Or is it assumed we have it for longer based on the myth that it is only diagnosed as a child?
I was surprised that the impact on QRISK3 is higher if you select Type 1 than if you select type 2 and this was the only explanation I could come up with.
It feels to me (as someone with no medical training) that the potential risk is higher for type 2 because you can have it for longer without any diagnosis and, hence, no treatment. But what do I know? I am just speculating which I know I shouldn't.

I’m sure I found out an answer to that a while ago when I was questioning the QRisk too. I can’t remember exactly, but it’s true that the Type 1 risk appears to be higher. For women with Type 1 after the menopause, for example, I’m sure I read the risk is 11 times higher. It was a scary figure. I think it was partly due to a potential wider range of blood sugar movement, inflammation and something else I can’t recall.

The QRisk thing is a blunt tool because it’s aimed at groups of people not individuals, but there does seem to be an increased risk. Depressing but true. I too have done the QRisk pretending I don’t have Type 1 and got a lovely 3%. It’s annoying and upsetting to add on the Type 1 and see the risk shoot up.

ETA - the thing I couldn’t remember is the immune system @helli as suggested in this:

https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.118.038137

.

 

[Anoniempie]

At my first consultation a couple of weeks after diagnosis, the DSN and dietician said my cholesterol was high. My Mum, her Mum and most of the women on that side of the family have had high cholesterol, so it wasn't much of a surprise. My Mum asked me to query it as she thought the level was fine - I can't remember precisely, but think it was around 5. DSN said it was higher than they would like for a diabetic and to reduce the risk of heart attack or stroke, I should consider statins. My Nan and several of her sisters suffered strokes and heart attacks in old age (they were a fit, healthy bunch, some like my Nan living into their 90s and one still going strong at 98). My Mums attitude to statins has always been - anything that reduces my high risk of stroke and that is an attitude I have also stuck with.

My initial dose was 20 I believe. A year in and my consultant reduced my dose as he worried my cholesterol was too low. I've been on them since 2018, no side effects (that I know of!). Like others have said, I sometimes forget to take them. I had two weeks without them when I stayed with my sister in Spain, but didn't worry too as I was swimming and eating extremely well whilst there.

Hi idk if you will see this but, i saw your post on scoliosis and that cough and i'd like to get in contact with you / know what your results showed? I'm exactly having what you described and i was told at a young age i had the possibility of getting scoliosis due to a slight curve they saw back at middle school. I'm going to the doctor, hopefully doing a scan, etc... is gonna take a while. You can send me a PM or reply below this post if you're willing to share ofcourse! I've been stressing over it so much and Google isn't helping. Had a little weird cough for over a month now and all of it first started with problems with my upper chest, back and a bit shoulders. (The doctor said it was stress back then, the cough/shortness of breath came a tiny bit after). I'm 21 M btw

Sorry for this being unrelated to the original message of this thread! I hope it's okay, i'm a bit in a little panic atm.

 

[everydayupsanddowns]

Hi idk if you will see this but, i saw your post on scoliosis and that cough and i'd like to get in contact with you / know what your results showed? I'm exactly having what you described and i was told at a young age i had the possibility of getting scoliosis due to a slight curve they saw back at middle school. I'm going to the doctor, hopefully doing a scan, etc... is gonna take a while. You can send me a PM or reply below this post if you're willing to share ofcourse! I've been stressing over it so much and Google isn't helping. Had a little weird cough for over a month now and all of it first started with problems with my upper chest, back and a bit shoulders. (The doctor said it was stress back then, the cough/shortness of breath came a tiny bit after). I'm 21 M btw

Sorry for this being unrelated to the original message of this thread! I hope it's okay, i'm a bit in a little panic atm.

Welcome to the forum @Anoniempie

Unfortunately @Ivostas66 hasn’t been on the forum for a few months, so may not pick up your message.

 

[Leadinglights]

Hi idk if you will see this but, i saw your post on scoliosis and that cough and i'd like to get in contact with you / know what your results showed? I'm exactly having what you described and i was told at a young age i had the possibility of getting scoliosis due to a slight curve they saw back at middle school. I'm going to the doctor, hopefully doing a scan, etc... is gonna take a while. You can send me a PM or reply below this post if you're willing to share ofcourse! I've been stressing over it so much and Google isn't helping. Had a little weird cough for over a month now and all of it first started with problems with my upper chest, back and a bit shoulders. (The doctor said it was stress back then, the cough/shortness of breath came a tiny bit after). I'm 21 M btw

Sorry for this being unrelated to the original message of this thread! I hope it's okay, i'm a bit in a little panic atm.

Some blood pressure medications can give you a cough but given your age it is unlikely you would be taking them.
Are you getting indigestion or acid reflux as that can cause a cough.
Hopefully you won't have to wait too long for a scan and you get some answers.

 

[SB2015]

That begs another question:
In addition to deciding the statin dose, how does a doc decide which statins to start a patient on?

I think it can depend on whether you get any side effects. I was started on atorvastatin and had no ill effects, just a reduction cholesterol levels as needed (started on 7) .

I know for BP at the time I was started on Ramipril (cheapest). It made me cough and I switched to Candasartan. Required dip in BP and no coughing. For my brother he tried three different ones before they got it right for him.

I think having decided to take them they will start with something and then see what happens. There are other options available and they can change to others if necessary.

 

[Ian Robinson]

I'm on 40mg Atorvastatin and my last reading was 3. I was told how important statins are to stop re offending strokes and I really don't want another one of them if I can help it

I've not experienced side effects while I've been on it and it's been 20 years now. A friend of mine was put on it and said it turned him in to a zombie so he refuse to take it