1. Get the Diabetes Forum App for your phone - available on iOS and Android.
    Dismiss Notice
  2. Guest, we'd love to know what you think about the forum! Take the Diabetes Forum Survey 2017 »
    Dismiss Notice
Dismiss Notice
Find support, ask questions and share your experiences. Join the community »

Statins & high cholesterol

Discussion in 'Newly Diagnosed' started by Rutho, Nov 27, 2017.

  1. TheBigNewt

    TheBigNewt Type 1 · Well-Known Member

    Messages:
    811
    Likes Received:
    263
    Trophy Points:
    83
    So are we talking FH here or not? FH homozygous we cannot be talking with you about, you'd already be dead. Those persons are often treated with plasmaphoresis, Now there are hugely expensive injections that can lower it quite a bit more than statins can. The hererozygous FH situation seems to be more possible in your case. What we know about that is that diet does virtually nothing. The genetics prevent the usual breakdown of cholesterol. Cardiac prognosis in hetero-FH is not good. Premature CAD is very common. Statins can make a difference. In fact they were originally developed to improve the rather bleak coronary prognosis in these people. I see men whose first coronary event was in their 40s, maybe a stent or 2. Bypass surgery around 55. Graft closures by age 60. Why someone like that would think eating avacados and beans was going to change anything I have no idea. Maybe more antioxidants!
     
  2. TheBigNewt

    TheBigNewt Type 1 · Well-Known Member

    Messages:
    811
    Likes Received:
    263
    Trophy Points:
    83
    Right, like targeting the highest risk groups. Like people who have already experienced a coronary event (heart attack, coronary stent or bypass). Once you do your future cause of death has likely been determined. So you either accept a treatment that's been unequivocally beneficial or you go on as people did before there was a good treatment option. Type 2 diabetics used to have only a few pill options for treatment, and some of them weren't too good. Now they have more.
     
    • Agree Agree x 1
  3. ringi

    ringi Type 2 · Well-Known Member

    Messages:
    1,445
    Likes Received:
    515
    Trophy Points:
    113
    @TheBigNewt "Consider the possibility of FH" is automatically added as a comment by the path lab's computer before the results are sent to the GP if TG is over the target range. When we log on to see our results, we see the labs comments as well as our GP's own comments, even if the GP does not agree with the lab's comments.
     
  4. Guzzler

    Guzzler Type 2 · Well-Known Member

    Messages:
    2,310
    Likes Received:
    1,954
    Trophy Points:
    158
    Hardly unequivocal, I suggest you view interviews with Aseem Malhotra and lectures by Sherif Sultan and then perhaps you may decide to revise your statement.
     
  5. LittleGreyCat

    LittleGreyCat Type 2 · Well-Known Member

    Messages:
    1,729
    Likes Received:
    1,206
    Trophy Points:
    178
    Accepting that you are not from around here, I still can't make head or tail of your post, apart from some derision about diet and an enthusiasm for statins (I think).

    You will note that a slight imbalance between LDL and HDL triggered a clinical warning on the surgery system in March, but a re-balancing between HDL and LDL (mainly a reduction in LDL) removed the concerns and the results were considered fine.

    That re-balancing was through diet alone. Given that it consisted more of egg and bacon than avocado and beans, diet and exercise seems to be effective.

    I am reasonably sure that I don't have Familial Hypercholesterolemia because I have a couple of friends of approximately the same age as me who do, and they have both had major cardio-vascular interventions already.

    As far as I can tell my vascular health is fine, including a recent scan for aortic aneurysm (age related standard check) which showed that my artery walls were fine - at least in that area.

    So high cholesterol (at least at the levels I posted) don't seem to be a major health issue. Time will tell, of course.

    Statins, however, are the Devil's work.
     
  6. TheBigNewt

    TheBigNewt Type 1 · Well-Known Member

    Messages:
    811
    Likes Received:
    263
    Trophy Points:
    83
    Ask Serif Sultan to explain why when they treated 165 pts who had an angiographically proven coronary blockage who were referred for a procedure with Lipitor 80mg/d. And the same number had the blocked vessel opened with a device and were treated "in the usual fashion". In the next 18 month 13% of the Lipitor patients had an "ischemic event". 21% of the other group had an ischemic event. Lipitor pts LDLc was reduced 47%. The usual care's was reduced 18%. Most of the difference was because of patients who ended up in the hospital with unstable coronary symptoms (again). All of these patients were stable to start out with. Their LDLc was 3.8. (New England Journal of Medicine, Bertram Pitt, et.al. 1999).
     
    #46 TheBigNewt, Nov 30, 2017 at 5:46 PM
    Last edited: Nov 30, 2017
  7. TheBigNewt

    TheBigNewt Type 1 · Well-Known Member

    Messages:
    811
    Likes Received:
    263
    Trophy Points:
    83
    Ask your friends who have FH what they think about statins now. To diagnose it you have to be referred for genetic testing. The high LDL probably just reminds the NP to consider it. Ultrasound for a AAA tells one nothing about your coronaries. Mainly for old people with high blood pressure who might blow a gasket and keel over. Before statins there wasn't much around to lower cholesterol. So diets were studied. The usual effect was about a 5% reduction over time. Better than nothing I guess, but not much.
     
  8. Guzzler

    Guzzler Type 2 · Well-Known Member

    Messages:
    2,310
    Likes Received:
    1,954
    Trophy Points:
    158
    All I ask is that you listen to Dr. Sultan's lecture to get a rounded opinion. It is often advantageous to see an argument from the opposite viewpoint so as to counter that argument.
     
  9. Bassiette

    Bassiette Type 1 · Well-Known Member

    Messages:
    72
    Likes Received:
    9
    Trophy Points:
    48
  10. TheBigNewt

    TheBigNewt Type 1 · Well-Known Member

    Messages:
    811
    Likes Received:
    263
    Trophy Points:
    83
    Got a link? Without even hearing it I'll guess that he is not speaking solely about persons with established atherosclerotic coronary disease, many of whom have what is considered to be an elevated LDL cholesterol. But I'm open to listening
     
  11. Guzzler

    Guzzler Type 2 · Well-Known Member

    Messages:
    2,310
    Likes Received:
    1,954
    Trophy Points:
    158
     
  12. Pinkorchid

    Pinkorchid Type 2 · Well-Known Member

    Messages:
    1,882
    Likes Received:
    1,511
    Trophy Points:
    198
    I would never encourage or discourage anyone about taking statins that is their choice. For me I take them because my doctor said there is overwhelming evidence within the medical profession that statins do help to prevent heart attacks and strokes in high risk patients and those with diabetes are high risk. She said her husband her brother and her mother all take them and she said would never let members of her own family take them if she thought statins were bad
     
    • Agree Agree x 1
  13. TheBigNewt

    TheBigNewt Type 1 · Well-Known Member

    Messages:
    811
    Likes Received:
    263
    Trophy Points:
    83
    The guy says it costs $14,000/year to treat somebody with a statin? I can buy 90 days of Lipitor 80mg without insurance for about $20. He says the incidence of rhabdomyolysis on Lipitor 80mg is 11%. Well in the SEARCH trial using simvastatin 80mg vs 20mg over 6.7 years the incidence of rhabdo was 0.4% in the high dose group, and incidence of myopathy was 0.9% in the high dose group. Simvistatin's side effects are generally higher than Lipitor's. He said 30% of people taking Liptor will get Type 2 diabetes. Maybe his people are eating too many avacados and taking too much CoQ10 (now there's a snake oil wannabe if there ever was one). I just don't see the stuff happening he throws up there. But I treat coronary disease he doesn't.
     
    • Like Like x 1
    • Informative Informative x 1
  14. LittleGreyCat

    LittleGreyCat Type 2 · Well-Known Member

    Messages:
    1,729
    Likes Received:
    1,206
    Trophy Points:
    178
    Funny you should ask that.
    One of my two friends with FH has rejected statins because of the severe side effects and now uses a diet (which suits her but wouldn't suit me) to bring her cholesterol levels right down. Heavy on the pro-biotics both spreads and drinks.

    As far as I know, no recent vascular problems.

    So no, she doesn't use statins, is very much against statins, but is still managing her cholesterol.

    From https://www.nhs.uk/conditions/high-cholesterol/diagnosis/

    "
    The National Institute for Health and Care Excellence (NICE)recommends that adults with a total cholesterol level of above 7.5mmol/l before treatment should be assessed for familial hypercholesterolaemia.

    If you've been diagnosed with familial hypercholesterolaemia, you'll be referred for a specialist assessment, which may include DNA testing to confirm the diagnosis.
    "

    My emphasis on the word "may" and "have".

    So in the UK (I assume especially for people who have been diagnosed for some years) the genetic testing is not always required. If it should be is, of course, another argument entirely. I suspect that it is more likely in a new diagnosis than for people diagnosed 10 years or more ago.

    You say about the aortic scan "Mainly for old people with high blood pressure who might blow a gasket and keel over." Not over here. Everyone of a certain age gets offered the test for free. They are rolling it out over different age groups to gradually sweep up everyone beyond a certain age, plus testing everyone who newly reaches a certain age. It is a preventative measure because aortic aneurysm is often undetectable through external symptoms.
    I think you may be illustrating some of the minor differences between UK and USA health care.
     
    • Like Like x 1
  15. Bluetit1802

    Bluetit1802 Type 2 · Oracle

    Messages:
    16,660
    Likes Received:
    25,747
    Trophy Points:
    278
    My husband self referred before being called up because he saw my dad die of this aged 72. He was clear and was told he wouldn't need another as there were no signs of any issues and this was unlikely to change.

    It is only offered to men aged 65 and over. It is not offered to women. This is what the NHS says (England only)

    In England, screening for AAA is offered to men during the year they turn 65.

    Men aged 65 or over are most at risk of AAAs. Screening can help spot a swelling in the aorta early on when it can be treated.

    Screening for AAA isn't routinely offered to:

    • women
    • men under 65
    • people who've already been treated for an AAA
    This is because the risk of an AAA is much smaller in these groups.

    You can ask for a scan to check for an AAA if you think you might need one but haven't been offered a screening test.

    https://www.nhs.uk/conditions/abdominal-aortic-aneurysm-screening/
     
    • Like Like x 1
  16. Pinkorchid

    Pinkorchid Type 2 · Well-Known Member

    Messages:
    1,882
    Likes Received:
    1,511
    Trophy Points:
    198
    I take statins because my doctor thinks that my high cholesterol is due to it being hereditary... this was long before I had T2... as I am not typical for it and there were no tests for it when my parents were alive. She said diet would not make any difference if it is hereditary only statins will lower it. I have been taking them for over 10 years now never had any side effects from them and still my cholesterol is higher than ideal. I now take 80mg Atorvastatin daily and my blood test next year will show if that has bought it down to an acceptable level
     
    • Agree Agree x 1
  17. derry60

    derry60 Prediabetes · Well-Known Member

    Messages:
    458
    Likes Received:
    222
    Trophy Points:
    63
    Which is causing diabetes through food or Statins. I am on Statins and have been for 14 years with no side effects. I was told that my sugars were high (Pre-Diabetic) I started the Keto diet back in may and have lost a good amount of weight with my sugars going from 6.5 fasting level and 6.8 or more 2 hours after eating to 5.2 fasting or less to 5.8 or 6.0 within two hours after eating. The only thing that I changed was the way that I ate,cutting out carbs and diet products. I am still on Statins yes my BG has dropped perfectly.
     
  18. derry60

    derry60 Prediabetes · Well-Known Member

    Messages:
    458
    Likes Received:
    222
    Trophy Points:
    63
    Same here after my heart attack 14 years ago. My total cholesterol was 6.8 before my heart attack and the Cardiologists told me that my good Cholesterol was not that great but not that bad either. My Cholesterol total is 4.1 and has been around this for years. I won't give up my Statin because All my blood and liver have come out fine, I have no side effects and am alive lol
     
    • Like Like x 1
  19. TheBigNewt

    TheBigNewt Type 1 · Well-Known Member

    Messages:
    811
    Likes Received:
    263
    Trophy Points:
    83
    FH is by definition a genetic "disease". True, no associated symptoms with it, but there aren't any associated symptoms with Type 2 diabetes either, at least not merely from the high sugar itself. And diet is ineffective in significantly lowering genetically controlled hypercholesterolemia. As I said before the people who have both FH genes ("homozygous") usually die of cardiovascular disease pretty young, and are rare. So your friend has 1 of the 2 genes ("heterozygous"), and their cholesterol usually runs well over 300mg/dl (around 8 there). They are quite high risk with no treatment, just like a Type 2 diabetic. Few on these forums ever argue not to treat diabetes with drugs, but there are many Type 2's that decline treatment with drugs. Oral hypoglycemic drugs have a far worse track record that statins with regard to side effects and complications, dating back to the infamous "UGDP Study" from the 70's, when I worked for Pfizer who sold one. Those drugs (sulfonylureas) were the precursors for metformin which is widely used today. That's not a subject for debate. So far statins offer the only effective treatment for FH other than plasmaphoresis (only used if you have both genes. It's similar to hemodialysis, very serious stuff), and the new very expensive injectables, which are actually quite effective but used very rarely now. The treatment for cholesterol isn't hyped much because it's so cheap. Statins are all generic now. The money in healthcare is made with revascularization procedures like coronary stents and bypass surgery, which is my field. But the big money in diabetes is in the expensive drugs like Januvia, Jardiance, Lantus, Novorapid, Treshiba. In the US they advertise on TV for diabetes treatments, never for statins. No money in that. And the diabetics in the ads look so HAPPY! They are buying bell peppers, running in the park, smiling and hugging their beautiful wives and grandkids. They don't show 'em getting stents implanted lol.
     
    • Informative Informative x 1
    #59 TheBigNewt, Dec 4, 2017 at 3:58 PM
    Last edited: Dec 4, 2017
  20. TheBigNewt

    TheBigNewt Type 1 · Well-Known Member

    Messages:
    811
    Likes Received:
    263
    Trophy Points:
    83
    Just saw a guy with Type 2, 74 years old. Was metformin now just diet, A1C=5.4 good control. Kidneys are so-so not normal. LDLc=3.4 (125mg/dl here). Had bad reaction to statin he took years ago for 6 months. Well the guy shut one of his 3 coronary arteries down 100% about 20 years ago, and didn't have any heart damage fortunately. What's amazing is his disease hasn't progressed to the other vessels. Probably 90% of dudes like him would have already had a bypass, maybe 2-5 stents, a heart attack or 2, maybe would have died. All he had this year was 2 stents. And he's pretty old too. He might make it to 80, but he's gonna die of coronary disease most likely. He would do better on a statin but he's done better than average without them. Go figure.
     
  • Meet the Community

    Find support, connect with others, ask questions and share your experiences with people with diabetes, their carers and family.

    Did you know: 7 out of 10 people improve their understanding of diabetes within 6 months of being a Diabetes Forum member. Get the Diabetes Forum App and stay connected on iOS and Android

    Grab the app!
  • Tweet with us

  • Like us on Facebook