Hi all. If like me you take statins but have reduced the carbs in your diet, you may find the following post of interest. It appeared on a different forum recently, composed by a former stalwart of this forum, who has kindly agreed to my reproducing it here:
‘Diabetes and carbs are like nut allergies and peanuts. There is no debate. Carbs raise blood sugar levels. End of story. It is so exact that insulin users, all of them, are taught to carb count to calculate the amount of insulin to use. For those not on insulin, there are some facts and some debate.
The main fact is; raised BGs will kill and cripple you. So they have to be controlled. Choices and debate are:-
Do I eat normal carbs and take the medicine? Any medicine that can control BGs adequately leads to insulin dependency, with its own risks, but this is an option. Most decide this is not the route. They are therefore left with fact 2; without strong medication, you have to reduce carbs or accept early death etc. So, the discussion point is around what you replace carbs with to maintain the necessary energy input. Some choose extra fat; but debate exists still about which fat is ok and does it really present its own health risk. For this reason, some choose extra protein; but debate still exists about the long term effect on kidneys. Arguments rage on diabetes forums about what is the better route. Virtually no carbs and loads of fat? No carbs and loads of protein? Higher carb intake with some medication? Atkins or dukan diet? Paleo diet?
But one thing is 100% agreed upon; you cannot eat “normal” levels of carbs without strong medication.
With statins, there remains far more debate and decisions to be taken in my view. So whereas 100% of diabetics agree about carbs, there is a far bigger split about statin use. Some agree with you and refuse to take them, including some on my “board”. Others recognise the risk, and choose to take them, like me. The difference is that with carbs, I can eat two slices of white bread and undertake a simple test to see the results on my BGs just 45 minutes later. You cannot “see” effects in the same way with statins.
That doesn’t of course mean the effects aren’t there. There are many studies and reports which suggest statins are bad and worse for you than the condition they seek to treat. Here’s one:-
articles.mercola.com/sites/articles/arch...in-side-effects.aspx
This raises the fact that statins can affect kidneys and other primary organs, and can actually cause diabetes. The latter point is wrong, although they can increase insulin resistance and lead to earlier and quicker development if the diabetes already exists. The former point is quite correct. Personally, I think the report is too alarmist, and comes from a site that is commercial and raises money by being alarmist. This next negative report is better, and slightly more scientific in its approach:-
www.medicinenet.com/statins/page2.htm
It points out the serious nature of both kidney and liver damage, whilst also pointing out that it’s rare and more commonly occurs when other drugs which interact are also taken.
So there is no doubt that side effects can occur. XX suffered them (muscle waste) but has switched to a different type and tests have showed that the problem is now eradicated. Although that is not to say another problem may not replace it!
So, why take these risks? Obviously, you have to believe that the potential benefit outweighs the risk. That is true of many drugs. Aspirin is shown to reduce risk of cardio incident, but has issues with stomach bleeds. Pills for high blood pressure are a necessity if all else fails, but carry their own risk. Insulin is a good example here of risk versus reward. So is there reward?
Having shown the negative reports on statins, there are also many positive ones.
This one came as a result of a study across 170,000 participants in 26 separate trials, so not a case of finding something from a small study and glorifying it. Here’s the link:-
www.ncbi.nlm.nih.gov/pubmed/21067804
This study was funded by UK medical research, the British heart foundation, the EC biomed program, Australian national health and medical research council and the national heart foundation. Some reasonable bodies with reasonable scientific prowess.
A key finding was “Across all 26 trials, all-cause mortality was reduced by 10% per 1•0 mmol/L”
And “Further reductions in LDL cholesterol safely produce definite further reductions in the incidence of heart attack, of revascularisation, and of ischaemic stroke, with each 1•0 mmol/L reduction reducing the annual rate of these major vascular events by just over a fifth. There was no evidence of any threshold within the cholesterol range studied, suggesting that reduction of LDL cholesterol by 2-3 mmol/L would reduce risk by about 40-50%.”
So pretty key statements.
A further study referred to use of Statins to reduce LDL in people without additional vascular risk, and without particularly raised LDL as well as those with:-
www.ncbi.nlm.nih.gov/pubmed/23440795
Across 57,000 participants, the findings were:-
“All-cause mortality was reduced by statins (OR 0.86, 95% CI 0.79 to 0.94); as was combined fatal and non-fatal CVD RR 0.75 (95% CI 0.70 to 0.81),”
A similar study looking specifically at people with low risk of disease stated “Reduction of LDL cholesterol with a statin reduced the risk of major vascular events (RR 0•79, 95% CI 0•77-0•81, per 1•0 mmol/L reduction), largely irrespective of age, sex, baseline LDL cholesterol or previous vascular disease, and of vascular and all-cause mortality.”
This was the study: www.ncbi.nlm.nih.gov/pubmed/22607822
Studies also suggest (although note the word “suggest”) that statins can reduce the risk of colorectal cancer and skin cancer. “By exploring the effects of statins on the process of cancer at the molecular level, researchers have found that statins work against critical cellular functions that may help control tumour initiation, tumour growth, and metastasis. Specifically, statins reduce (or block) the activity of the enzyme HMG-CoA reductase and thereby reduce the levels of mevalonate and its associated products. The mevalonate pathway plays a role in cell membrane integrity, cell signaling, protein synthesis, and cell cycle progression, all of which are potential areas of intervention to arrest the cancer process.”
This is the report www.cancer.gov/cancertopics/factsheet/p ... on/statins
Here’s another on prostrate cancer www.medicalnewstoday.com/articles/260029.php
There are also of course reports suggesting there is currently no proof regarding reduction in deaths from cancer amongst those on statins, and indeed that statins can cause cancer!
I hopefully list all these reports to show that decisions on statins are not “fait accompli”, and that there is not one fixed answer.
I also realise statins are prescribed purely on the basis of high total serum cholesterol, whereas it’s only the LDL component (and some would argue not all of that) that is dangerous. However, I think it’s unlikely that anyone with high total cholesterol would have low trigs and low LDL, with all the rest made up of HDL. So it’s a convenience that is probably right most of the time to prescribe on the cheaper diagnosis of total cholesterol. One would hope (maybe forlornly?) that if a young, fit individual had high cholesterol, more tests would be undertaken prior to prescription.
Regarding LDL components, there are lots of discussions about soft and spikey LDL, but the only scientific breakdown of LDL I can find is LDL and VLDL, with VLDL being the worst. But as statins reduce all LDL, and the studies above show a considerable improvement in all-cause mortality of reducing LDL in total, they still seem to present a positive. Of course, diet should be controlled to control LDL, but again, the studies show that cardio issues and all-cause mortality improves even in people with low levels of LDL, so statins can be seen as an adjunct to overall treatment.
Liver (and potentially kidney) damage is of course a concern. It can be checked with tests, although these are not carried out as standard because of cost. However, one advantage of being diabetic is that I now have annual liver and kidney tests. These are extensive and include tests on protein, creatinine ratio, Albumin and micro-albumin and lots of others I can’t spell! Last test was last month, and was totally normal. So guess I’m lucky.
So, in summary, whereas carbs are a no-brainer, statins are more of a discussion/decision for me. Even with my good blood sugar levels, I am more at risk of a cardio event. A non-diabetic with HbA1c of 5.5% has his risk of a cardio event increased by 21% over that of a person with a more normal 4.9% with the same other bio factors (weight etc). At 5.7%, my risk is up 25%ish. As my HbA1c is likely to continue to increase with time, anything to mitigate that is welcome.
For now, I’ve seen evidence across 100’s of ‘000s of people of a significant reduction in cardio risk, with the added extra potential of possible cancer avoidance. Against that, I’m taking a potentially dangerous drug, but am tested annually for side effects which, for now, are zero.
It could be that further evidence will emerge which will make me change my decision, but for now it is what it is.’
‘Diabetes and carbs are like nut allergies and peanuts. There is no debate. Carbs raise blood sugar levels. End of story. It is so exact that insulin users, all of them, are taught to carb count to calculate the amount of insulin to use. For those not on insulin, there are some facts and some debate.
The main fact is; raised BGs will kill and cripple you. So they have to be controlled. Choices and debate are:-
Do I eat normal carbs and take the medicine? Any medicine that can control BGs adequately leads to insulin dependency, with its own risks, but this is an option. Most decide this is not the route. They are therefore left with fact 2; without strong medication, you have to reduce carbs or accept early death etc. So, the discussion point is around what you replace carbs with to maintain the necessary energy input. Some choose extra fat; but debate exists still about which fat is ok and does it really present its own health risk. For this reason, some choose extra protein; but debate still exists about the long term effect on kidneys. Arguments rage on diabetes forums about what is the better route. Virtually no carbs and loads of fat? No carbs and loads of protein? Higher carb intake with some medication? Atkins or dukan diet? Paleo diet?
But one thing is 100% agreed upon; you cannot eat “normal” levels of carbs without strong medication.
With statins, there remains far more debate and decisions to be taken in my view. So whereas 100% of diabetics agree about carbs, there is a far bigger split about statin use. Some agree with you and refuse to take them, including some on my “board”. Others recognise the risk, and choose to take them, like me. The difference is that with carbs, I can eat two slices of white bread and undertake a simple test to see the results on my BGs just 45 minutes later. You cannot “see” effects in the same way with statins.
That doesn’t of course mean the effects aren’t there. There are many studies and reports which suggest statins are bad and worse for you than the condition they seek to treat. Here’s one:-
articles.mercola.com/sites/articles/arch...in-side-effects.aspx
This raises the fact that statins can affect kidneys and other primary organs, and can actually cause diabetes. The latter point is wrong, although they can increase insulin resistance and lead to earlier and quicker development if the diabetes already exists. The former point is quite correct. Personally, I think the report is too alarmist, and comes from a site that is commercial and raises money by being alarmist. This next negative report is better, and slightly more scientific in its approach:-
www.medicinenet.com/statins/page2.htm
It points out the serious nature of both kidney and liver damage, whilst also pointing out that it’s rare and more commonly occurs when other drugs which interact are also taken.
So there is no doubt that side effects can occur. XX suffered them (muscle waste) but has switched to a different type and tests have showed that the problem is now eradicated. Although that is not to say another problem may not replace it!
So, why take these risks? Obviously, you have to believe that the potential benefit outweighs the risk. That is true of many drugs. Aspirin is shown to reduce risk of cardio incident, but has issues with stomach bleeds. Pills for high blood pressure are a necessity if all else fails, but carry their own risk. Insulin is a good example here of risk versus reward. So is there reward?
Having shown the negative reports on statins, there are also many positive ones.
This one came as a result of a study across 170,000 participants in 26 separate trials, so not a case of finding something from a small study and glorifying it. Here’s the link:-
www.ncbi.nlm.nih.gov/pubmed/21067804
This study was funded by UK medical research, the British heart foundation, the EC biomed program, Australian national health and medical research council and the national heart foundation. Some reasonable bodies with reasonable scientific prowess.
A key finding was “Across all 26 trials, all-cause mortality was reduced by 10% per 1•0 mmol/L”
And “Further reductions in LDL cholesterol safely produce definite further reductions in the incidence of heart attack, of revascularisation, and of ischaemic stroke, with each 1•0 mmol/L reduction reducing the annual rate of these major vascular events by just over a fifth. There was no evidence of any threshold within the cholesterol range studied, suggesting that reduction of LDL cholesterol by 2-3 mmol/L would reduce risk by about 40-50%.”
So pretty key statements.
A further study referred to use of Statins to reduce LDL in people without additional vascular risk, and without particularly raised LDL as well as those with:-
www.ncbi.nlm.nih.gov/pubmed/23440795
Across 57,000 participants, the findings were:-
“All-cause mortality was reduced by statins (OR 0.86, 95% CI 0.79 to 0.94); as was combined fatal and non-fatal CVD RR 0.75 (95% CI 0.70 to 0.81),”
A similar study looking specifically at people with low risk of disease stated “Reduction of LDL cholesterol with a statin reduced the risk of major vascular events (RR 0•79, 95% CI 0•77-0•81, per 1•0 mmol/L reduction), largely irrespective of age, sex, baseline LDL cholesterol or previous vascular disease, and of vascular and all-cause mortality.”
This was the study: www.ncbi.nlm.nih.gov/pubmed/22607822
Studies also suggest (although note the word “suggest”) that statins can reduce the risk of colorectal cancer and skin cancer. “By exploring the effects of statins on the process of cancer at the molecular level, researchers have found that statins work against critical cellular functions that may help control tumour initiation, tumour growth, and metastasis. Specifically, statins reduce (or block) the activity of the enzyme HMG-CoA reductase and thereby reduce the levels of mevalonate and its associated products. The mevalonate pathway plays a role in cell membrane integrity, cell signaling, protein synthesis, and cell cycle progression, all of which are potential areas of intervention to arrest the cancer process.”
This is the report www.cancer.gov/cancertopics/factsheet/p ... on/statins
Here’s another on prostrate cancer www.medicalnewstoday.com/articles/260029.php
There are also of course reports suggesting there is currently no proof regarding reduction in deaths from cancer amongst those on statins, and indeed that statins can cause cancer!
I hopefully list all these reports to show that decisions on statins are not “fait accompli”, and that there is not one fixed answer.
I also realise statins are prescribed purely on the basis of high total serum cholesterol, whereas it’s only the LDL component (and some would argue not all of that) that is dangerous. However, I think it’s unlikely that anyone with high total cholesterol would have low trigs and low LDL, with all the rest made up of HDL. So it’s a convenience that is probably right most of the time to prescribe on the cheaper diagnosis of total cholesterol. One would hope (maybe forlornly?) that if a young, fit individual had high cholesterol, more tests would be undertaken prior to prescription.
Regarding LDL components, there are lots of discussions about soft and spikey LDL, but the only scientific breakdown of LDL I can find is LDL and VLDL, with VLDL being the worst. But as statins reduce all LDL, and the studies above show a considerable improvement in all-cause mortality of reducing LDL in total, they still seem to present a positive. Of course, diet should be controlled to control LDL, but again, the studies show that cardio issues and all-cause mortality improves even in people with low levels of LDL, so statins can be seen as an adjunct to overall treatment.
Liver (and potentially kidney) damage is of course a concern. It can be checked with tests, although these are not carried out as standard because of cost. However, one advantage of being diabetic is that I now have annual liver and kidney tests. These are extensive and include tests on protein, creatinine ratio, Albumin and micro-albumin and lots of others I can’t spell! Last test was last month, and was totally normal. So guess I’m lucky.
So, in summary, whereas carbs are a no-brainer, statins are more of a discussion/decision for me. Even with my good blood sugar levels, I am more at risk of a cardio event. A non-diabetic with HbA1c of 5.5% has his risk of a cardio event increased by 21% over that of a person with a more normal 4.9% with the same other bio factors (weight etc). At 5.7%, my risk is up 25%ish. As my HbA1c is likely to continue to increase with time, anything to mitigate that is welcome.
For now, I’ve seen evidence across 100’s of ‘000s of people of a significant reduction in cardio risk, with the added extra potential of possible cancer avoidance. Against that, I’m taking a potentially dangerous drug, but am tested annually for side effects which, for now, are zero.
It could be that further evidence will emerge which will make me change my decision, but for now it is what it is.’
