Statins

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Sadsac

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I am waiting on a follow up call from the nurse about my latest hbaC1 results (drop from 114 to 57). When I was first diagnosed in January I refused all medication. I said I would get things under control myself. I feel I’m on the right road. My concern is that I know the nurse wants me to start taking statins. My cholesterol was well within normal limits in January at my initial appointment but she said I still had to have them because of diabetes. Is this really a thing?
 
Sadsac said:
I am waiting on a follow up call from the nurse about my latest hbaC1 results (drop from 114 to 57). When I was first diagnosed in January I refused all medication. I said I would get things under control myself. I feel I’m on the right road. My concern is that I know the nurse wants me to start taking statins. My cholesterol was well within normal limits in January at my initial appointment but she said I still had to have them because of diabetes. Is this really a thing?
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Yes it's a thing!! My cholesterol was 4 when I was diagnosed. GP said he would like it lower as Diabetics are more likely to suffer heart disease and strokes!! Luckily I don't have any side effects and cholesterol in February was 2.4.
 
Even if your cholesterol is OK statins may still be recommended if you have certain long-term conditions, one of which is diabetes. It was discussed at my recent diabetes review but the DN didn't say I had to have them. I got the impression that it was my choice.
 
I was told this is NICE guidelines for everyone over the age of 50 with diabetes. It is based on study done with a group so f people with diabetes who do not exercise and are overweight. There has been no study to understand the benefit for people with diabetes who are a healthy weight and do plenty of exercise.
 
helli said:
There has been no study to understand the benefit for people with diabetes who are a healthy weight and do plenty of exercise.
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Which is me, and might explain why my DN didn't push them.
 
High blood sugar levels is linked with poor lipid metabolism and especially high triglycerides, which lead to insulin resistance and impaired beta cell response. Also the lack of insulin prevents lipids from behind metabolised properly. Hence why T2s are offered statins, especially if glucose levels are high. (And having poor lipid control can affect glucose control.)
 
harbottle said:
High blood sugar levels is linked with poor lipid metabolism and especially high triglycerides, which lead to insulin resistance and impaired beta cell response. Also the lack of insulin prevents lipids from behind metabolised properly. Hence why T2s are offered statins, especially if glucose levels are high. (And having poor lipid control can affect glucose control.)
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If that's the case, why are people with Type 1 with HBA1C below the pre-diabetic level offered them?
 
helli said:
There has been no study to understand the benefit for people with diabetes who are a healthy weight and do plenty of exercise.
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I’m not sure that’s true. The Hope3 trial (many years ago) looked into primary prevention for people with diabetes at low-moderate risk - I think it was in T1s, but can’t remember if exclusively so. It was a pretty big trial and extended previous work on primary prevention in people who didn’t have the more ‘obvious’ markers of risk such as overweight/obesity and sub-optimal glucose management.

In other words, was it worth it for people who didn’t have a history of existing heart disease, and were actually pretty well managed. They found a significant risk reduction in the statin arm.
 
helli said:
If that's the case, why are people with Type 1 with HBA1C below the pre-diabetic level offered them?
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I don't know, talk to the people who make the rules. I'm mainly talking about metabolic syndrome which is a marker of T2D and indication of insulin resistance.
 
There are discussions about this elsewhere on this forum that are worth looking at. As helli said these are NICE guidelines, you don't have to take them but most doctors and nurses would like you to, and can get very pushy about it. As always the decision depends upon individual circumstances.
 
Nice guideline NG238 covers it.
Prescribing is done by consent with such issues , ie they offer to prescribe something but you decide if you wish to accept it. You have a choice .
 
I have declined statins so far. I am 60 and my cholesterol is usually pretty stable around mid 4s, so higher than the guidelines of being below 4, but I am pretty fit and healthy and I manage my diabetes well, so I don't feel that I want to take extra medication at this time. My nurse and consultant are OK with my decision and I reserve the right to change my mind, which I would likely do if my levels suddenly rose significantly. I would reconsider at 6 or 7 I think, but possibly even mid 5s. I don't know until I get to that point and might depend on other factors like whether I was able to maintain my fitness etc.
Just really want to say that as others have mentioned, it is your body and your choice but do some research and make an educated decision based on your results and your lifestyle and family history rather than a gut feeling.
 
I have been told to go on them as my cholesterol despite changing my diet has been at 5-5.5 for a few years. In November I completely changed my diet to cut out most saturated fats and generally eat better.
This was because in October the consultant said I should go on statins but reading the side effects it said they could impact glucose levels so I spoke with my DSN and she agreed I should go hard on my diet and see if we can fix it. Latest bloods 5.2 so down, and both sets of bloods since November show good cholesterol levels are up and bad cholesterol is down so I am making progress.
DSN on Tuesday said carry on and raise with the consultant next appointment.
I was told it is common for all diabetics to be on statins once we have had diabetes for a while our heart has been stressed out, but I just don’t want anything else impacting my glucose levels, so we will see.
 
I was told by a consultant that just being Type 1, because your blood sugars tend to spike more than a non-D, causes inflammation in the blood vessel lining.
I resisted statins for years, but when my cholesterol levels started to creep up as I got older, I decided I'd go on them if my total cholesterol level hit 6, which it did about a year ago, so I agreed to give a low dose a try. (I’d been on them once when I was first diagnosed and misdiagnosed as Type 2, and I had muscle pains in my arm as and legs. This might have been linked to my falling BG levels, as they had been high for some time, but I was wary, having read about SEs of Statins. Having agreed to try a different sort, I find I’m OK on them now)
 
I've just started statins, despite non diabetic a1c. I tried a really healthy diet first (no butter, biccys etc, no cheese, cholesterol lowering drinks) but git a very modest reduction, so went on statins. No effect on blood glucose levels for me, no side effects.
End of day, its your choice
 
When I mentioned my problems with aches and pains and my memory being affected, my sister revealed that her husband had been prescribed statins, and she felt that she'd lost the man she married.
He can no longer hold a conversation without getting flustered, he can't follow the plotline of a film, he no longer reads, she feels anxious when he is driving as he can't follow their planned route and they end up on the wrong road even when she tries to prompt him which turn to take on a roundabout. He was always very calm and kind, now he's becoming easily angered and belligerent with her, and with strangers in the street. She is concerned, as he's so big and strong, she is a foot shorter, and lightly built, she doesn't feel safe.
Because his GP has prescribed them, he will not consider stopping them even though the statin is 'precautionary'.
 
I wasn't too keen on taking a Statin but when my cholestrol reached 7 I was tired of the badgering reached and I decided it was time. However, after three months with no noticeable side effects. I had a liver blood test and while the statin4
had reduced my cholestrol to 3.2 it had also elevated my liver enzymes. The surgery called me for an urgent appointment and took me off the statin. Cue blood tests, ultra sound and a full liver screen for disease .

After a few weeks everything had returned to normal and no liver disease. I still have to make a decision about another statin but am quite nervous about the whole thing.
 
Leadinglights said:
Since you cholesterol is now at 3.2, you could always play it by ear and have your cholesterol checked after not taking the statin for a few months
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That is what I decided to do, wait until my next blood test in October and see what the increase will no doubt be.
 
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