Statins

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bev said:
Phew - thanks Northerner! Why does it have to be lower for diabetics?:confused:Bev
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Because Diabetics, due to the biochemistry of the condition, suffer from Diabetic Dyslipidemia ( elevated Total Cholesterol, elevated LDL, depressed HDL). So we are at particular risk of atherothrombotic vascular disease ( horrible arteries and dickie tickers). For each 1% reduction in LDL gives a 2% fall in cardiovascular events and each 1% rise in HDL produces a 3% fall. James H. O'Keefe ( a leading cardiologist from the Midwest and big on lipids - anyone interested in this subject should read O'Keefe before Kendrick !) says "Optimization of the Lipid profile is the SINGLE MOST IMPORTANT INTERVENTION for improving cardiovascular prognosis in Type 2 diabetes".
O'Keefe, Diabetes Essentials.
Basically diabetics are almost as bad at handling cholesterol as we are handling glucose. If the Total Chols rise you can bet with us its the bad stuff ( LDl and VLDL) that's causing the rise not the good stuff. So the rules are set more stringent targets for dmers than "civilians", get the LDL down ( optimal range 50-70 mg dl ) and the HDL up. HOW ? Diet and exercise of course and by Statins easiest of all - they always work.
 
Peter C said:
Because Diabetics, due to the biochemistry of the condition, suffer from Diabetic Dyslipidemia ( elevated Total Cholesterol, elevated LDL, depressed HDL). So we are at particular risk of atherothrombotic vascular disease ( horrible arteries and dickie tickers). For each 1% reduction in LDL gives a 2% fall in cardiovascular events and each 1% rise in HDL produces a 3% fall. James H. O'Keefe ( a leading cardiologist from the Midwest and big on lipids - anyone interested in this subject should read O'Keefe before Kendrick !) says "Optimization of the Lipid profile is the SINGLE MOST IMPORTANT INTERVENTION for improving cardiovascular prognosis in Type 2 diabetes".
O'Keefe, Diabetes Essentials.
Basically diabetics are almost as bad at handling cholesterol as we are handling glucose. If the Total Chols rise you can bet with us its the bad stuff ( LDl and VLDL) that's causing the rise not the good stuff. So the rules are set more stringent targets for dmers than "civilians", get the LDL down ( optimal range 50-70 mg dl ) and the HDL up. HOW ? Diet and exercise of course and by Statins easiest of all - they always work.
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I am Type 1 though Peter, and don't have insulin resistance which I understand is the problem causing what you describe. When you say 1% rise or fall do you mean 1 mmol/l? :confused:
 
Glad to hear you ditched the statins northe! Your total cholesterol was sounding VERY low and I was wondering why they kept you on them, as it seemed unnecessary.
 
I am still so confused about all this...i regard myself as quite intelligent but biology and chemistry not my strong points...I took Physics...so..please translate for me if you can my latest Lipids...
Total 6.5
LDL 3.7
HDL 1.1
TRIG 3.8

..North if you had these readings what changes would you make...or would you just write a poem ??
 
am64 said:
I am still so confused about all this...i regard myself as quite intelligent but biology and chemistry not my strong points...I took Physics...so..please translate for me if you can my latest Lipids...
Total 6.5
LDL 3.7
HDL 1.1
TRIG 3.8

..North if you had these readings what changes would you make...or would you just write a poem ??
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I'm no expert am but... 😉

I think your LDL cholesterol and trigs seem a bit high and your HDL is low. Ideally you want a higher HDL and try to lower the others. So cut down on bad fats and try to eat more oily fish.

*awaits a more scientific, clever person to reply*

:D
 
Northerner said:
I am Type 1 though Peter, and don't have insulin resistance which I understand is the problem causing what you describe. When you say 1% rise or fall do you mean 1 mmol/l? :confused:
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Hello Northerner,

You are not off the hook with Lipids because you are T1 though ...
http://www.ncbi.nlm.nih.gov/pubmed/19733492

And this Presentation emphasises that even T1s with good control have qualitative issues with lipids
http://www.uchsc.edu/misc/diabetes/slides/keystone05/Eckel.ppt#379,10,Slide 10
 
katie said:
I'm no expert am but... 😉

I think your LDL cholesterol and trigs seem a bit high and your HDL is low. Ideally you want a higher HDL and try to lower the others. So cut down on bad fats and try to eat more oily fish.

*awaits a more scientific, clever person to reply*

:D
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nursey told me to worry about trigs not others...but im not surprised as had been eating crap cos feeling crap for a few months...going through bit of that last week but laid off the really bad stuff...so learning...slowly
thanks X🙂
 
am64 said:
nursey told me to worry about trigs not others...but im not surprised as had been eating crap cos feeling crap for a few months...going through bit of that last week but laid off the really bad stuff...so learning...slowly
thanks X🙂
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oh im totally with you there, I have been eating crap for months too for the same reasons and I still slip into the comfort eating alot. We can only try our best to change habbits :D I might start trying to eat oily fish actually, im not a fan though :(
 
Peter C said:
Hello Northerner,

You are not off the hook with Lipids because you are T1 though ...
http://www.ncbi.nlm.nih.gov/pubmed/19733492

And this Presentation emphasises that even T1s with good control have qualitative issues with lipids
http://www.uchsc.edu/misc/diabetes/slides/keystone05/Eckel.ppt#379,10,Slide 10
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Thanks for the links Peter, much appreciated. I think my main concern really is that, by taking statins my total cholesterol has dipped to 2.4 in the past and is currently 3.2. I don't know the split, because the consultant seemed reluctant to tell me for some reason, just said my HSL was higher than LDL.

I think that this is too low, and that I am capable of maintaining a healthy level (whether that be 4 or 5) without the potential risk posed by statins. They only seem to offer a slight risk reduction in one area for an unknown risk in another, so it's a trade off for me.
 
katie said:
oh im totally with you there, I have been eating crap for months too for the same reasons and I still slip into the comfort eating alot. We can only try our best to change habbits :D I might start trying to eat oily fish actually, im not a fan though :(
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i found out recently that walnuts...which are in abundance at mo around here also have the omega 3....but give me a nice kipper XXX:D
 
am64 said:
i found out recently that walnuts...which are in abundance at mo around here also have the omega 3....but give me a nice kipper XXX:D
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nuts are more my thing! problem is i can't eat a few at a time, have to eat the whole lot!
 
Kippers, oooh, I haven't had one of them in years. I'm going on a kipper hunt in the morning.
 
am64 said:
same xxx but better than pile of chips and mayo!!
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I did that to my chips the other day and my brother nearly fainted. He reckons I came home just in time. We're apparently supposed to use brown sauce up here.
 
Cripes Northener....you have really set the cat amongst the pigeons in my house. My partner has great medical knowledge, when I opened dialog with her on this........I got chapter and verse as to why I should be on Statins. I quoted you!!!!!😉, also printed this out for her

http://www.spiked-online.com/Articles/0000000CAE78.htm

An interesting read, without doubt. I am just as confused now, as I was this time yesterday.....so I'm giving myself over to nature😉:D
 
DiabeticDave said:
Cripes Northener....you have really set the cat amongst the pigeons in my house. My partner has great medical knowledge, when I opened dialog with her on this........I got chapter and verse as to why I should be on Statins. I quoted you!!!!!😉, also printed this out for her

http://www.spiked-online.com/Articles/0000000CAE78.htm

An interesting read, without doubt. I am just as confused now, as I was this time yesterday.....so I'm giving myself over to nature😉:D
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Thanks for the link Dave, it's an excellent synopsis of the book and you can probably appreciate that the extra detail in the book makes the arguments even more compelling.

I'm certainly not suggesting everyone should abandon their statins, but I do think that it's necessary to have an informed opinion on the matter - just as it is with diabetes care. Sorry if I caused dissent in the ranks! It may be that, for you, you are better off taking statins than not.

My own personal position is that my cholesterol level was not high to start with, studies suggest that having a LOW level will lead to me dying younger of something else, and there are as yet unknown (and some serious known) side-effects of statins. Add to that the purely statistical possibility that I might not die of a heart attack until a couple of months later in my life by taking statins and I'd rather take my chances.
 
Statistics about survival (a branch of epidemiology) don't say anything about how long you as an individual will survive, just how a population of people of your age, sex and medical history will survive. So, the "couple of months" is an average, which includes some who die earlier, some who live for years longer etc, not that each person will live exactly a few months longer without a heart attack on statins than without. It's so difficult to account for confounding factors such as physical activity, mental attitude, social situation etc, that only very crude measures are used - often men living alone do worse than those living with partners, for example, but that fails to allow for those unhappily living together, for example.
 
Copepod said:
Statistics about survival (a branch of epidemiology) don't say anything about how long you as an individual will survive, just how a population of people of your age, sex and medical history will survive. So, the "couple of months" is an average, which includes some who die earlier, some who live for years longer etc, not that each person will live exactly a few months longer without a heart attack on statins than without. It's so difficult to account for confounding factors such as physical activity, mental attitude, social situation etc, that only very crude measures are used - often men living alone do worse than those living with partners, for example, but that fails to allow for those unhappily living together, for example.
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Indeed. And as Kendrick makes the point in his book, the results of a lot of these studies are being applied to people who have completely different factors in their lives - not least if you live in a different country! For example, the Framingham study really only relates to people who live in Framingham - if the conclusions were applied to the French then the projections are entirely misleading.

What, for example, is considered too low a cholesterol level? The Japanese have much lower levels than Westerners and much lower incidence of heart disease - but a much higher rate of stroke! In my own particular case there didn't seem to be any alarm whatsoever that my levels were so low, with the clear intention of driving them even lower if possible - i.e. my dose of statins wasn't reduced at all.
 
I'd be happy to extrapolate findings from Framingham Heart Study to other people born around 1948 in Massachusetts, and New England, USA, but links get more tenuous the further away you travel in time and space - for example, mothers of mainland Europeans born in 1948 had all lived through the Second World War, which was a very different experience in Europe than USA. When racial groups are considered, things get even more complicated - the genetic background that helped you to survive in the Indian subcontinent or West Africa or Caribbean in past generations may be very different to what helps you to survive in modern western societies - resistance to malaria, variable food supplies etc were more important, but there's no malaria in Europe now (it was present in fen areas of England into 17th century and in Sardinia until 1950, for example) and famines don't affect food supplies in Europe. Let's not forget about health issues in developing countries, where impregnated bednets can prevent many insect borne diseases and safe water supplies and oral rehydration solutions (made from sugar / fizzy drinks / salt / special measuring spoons - see http://www.talcuk.org/accessories/sugar-and-salt-measures.htm ) can save many lives.
 
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