For those worried about cholesterol levels..

[bulkbiker]

I went from non-diabetic to diabetic in the space of 12 months, and my HbA1c on diagnosis was only 53, so I'm not too worried about prior damage either. I hope your theory that damage can be reversed is right.

Me too!

 

[Daphne917]

I went from non-diabetic to diabetic in the space of 12 months, and my HbA1c on diagnosis was only 53, so I'm not too worried about prior damage either. I hope your theory that damage can be reversed is right.

My hba1c was 48 on diagnosis but rose to 54 when I started taking statins. Hopefully the 8-10 weeks I was on them didn't do too much damage!

 

[LittleGreyCat]

Extracted from the article:

We have shown that according to authoritative CVD guidelines, 75% of the adult Norwegian population would be deemed at risk for CVD and in need of clinical attention (advice and supervision) [25,26]. Consequently, we have questioned the theoretical basis of the guidelines. In the present study, we look specifically at the validity of guidelines’ risk estimations involving cholesterol. In particular, we challenge the widespread assumption of a linear relationship between total cholesterol levels and disease development (expressed as mortality in our analysis).

I have read much the same about the UK; current guidelines allegedly suggest that every male over 60 and female over 75 should be on statins.

Some clinicians find this hard to credit.

 

[NoCrbs4Me]

Extracted from the article:



I have read much the same about the UK; current guidelines allegedly suggest that every male over 60 and female over 75 should be on statins.

Some clinicians find this hard to credit.

The current guidelines also say that EVERY person diagnosed as diabetic should be on a statin.

 

[sally and james]

you have no idea what damage was done before gaining control of BS, and having gained control this damage is most likely irreversible.

These are the words of Bluetit's GP and, quite honestly, I find them complete nonsense. I'm sure many of us can produce examples from our own experience of reversed damage. The Big One for us was the reversal of prolific retinopathy. Left to its own devices, the body is very good at healing itself, after all, what did it do for millions of years before we had the benefits of Big Pharma?
Sally

 

[Bluetit1802]

These are the words of Bluetit's GP and, quite honestly, I find them complete nonsense. I'm sure many of us can produce examples from our own experience of reversed damage. The Big One for us was the reversal of prolific retinopathy. Left to its own devices, the body is very good at healing itself, after all, what did it do for millions of years before we had the benefits of Big Pharma?
Sally

I should have made it clearer that she was referring to CVD rather than general diabetic complications. We had been discussing the ins and outs of the Q-Risk formula.

 

[sally and james]

I should have made it clearer that she was referring to CVD rather than general diabetic complications. We had been discussing the ins and outs of the Q-Risk formula.

While I hear what you say, @Bluetit1802 , I wonder what her evidence is that once you have had a high sugar level, the damage in CVD terms is irreversible. I can't imagine that there is enough of us, being closely monitored, for long enough to say that there is nothing you can do about CVD risk, apart from take statins and consume the Eat Well plate.
Sally

 

[Gannet]

Extracted from the article:



I have read much the same about the UK; current guidelines allegedly suggest that every male over 60 and female over 75 should be on statins.

Some clinicians find this hard to credit.

A 101 year old gentleman I know was put on statins a couple of years ago. He was also on several different medications for high blood pressure, pain etc etc.... To cut a long story short, after collapsing he was eventually taken off the lot ...... and felt much better.

 

[Bluetit1802]

While I hear what you say, @Bluetit1802 , I wonder what her evidence is that once you have had a high sugar level, the damage in CVD terms is irreversible. I can't imagine that there is enough of us, being closely monitored, for long enough to say that there is nothing you can do about CVD risk, apart from take statins and consume the Eat Well plate.
Sally

I completely agree. I have no idea what her evidence is. It just threw me a bit.

 

[DavidGrahamJones]

It might have been said, but seeking out the names of those who are on the panel of NICE advisor, specifically for cholesterol levels, then look into who they are funded by or salaried to, basically who gives them money.

I'm attaching a graph that was put together by the British Heart Foundation and the World Health Organisation. It's All Cause Mortality against Total Cholesterol. The dotted red line is heart disease. The cholesterol units are in Mg/Dl which I converted to mmol/l. the numbers we're more familiar with in the UK. I've added the conversions to the chart at the bottom, bit cluttered but I tried.

If you can open it up and enlarge it (my PDF program lets me do that), have a look at bottom right, just above 230/5.4978 and it says Cardiovascular diseases and total cholesterol are weakly related.

It's dated 2002 but I've seen a much later version which I can't find, it was post 2010.

Hopefully now in the right place.

 

[Pinkorchid]

My hba1c was 48 on diagnosis but rose to 54 when I started taking statins. Hopefully the 8-10 weeks I was on them didn't do too much damage!

Mine was 46 on T2 diagnosis I have annual blood tests so knew I did not have it longer than a year. It went down to 44 and then 42 at my next two HbA1c's and I was taking statins and had been for a few years. My doctor would like me to get my cholesterol under 5 it was 5.2 the last time I had my HbA1c

 

[NoCrbs4Me]

Mine was 46 on T2 diagnosis I have annual blood tests so knew I did not have it longer than a year. It went down to 44 and then 42 at my next two HbA1c's and I was taking statins and had been for a few years. My doctor would like me to get my cholesterol under 5 it was 5.2 the last time I had my HbA1c

You should show them that study and tell them you'd prefer your TC >7.

 

[bulkbiker]

I completely agree. I have no idea what her evidence is. It just threw me a bit.

I can almost guarantee that there is none... and she was making it up.. or half remembered something from her training in 1980..

 

[lindisfel]

Isn't the problem with the general population that they have pretty much all got low HDL? If you do not take hdl into the equation you can get some idea why they just prescribe statins on total cholesterol! It doesn't make sense to me but its policy.D

 

[Bluetit1802]

Isn't the problem with the general population that they have pretty much all got low HDL? If you do not take hdl into the equation you can get some idea why they just prescribe statins on total cholesterol! It doesn't make sense to me but its policy.D

NICE now recommends the Total/HDL ratio to be calculated for CVD issues and statins. Additionally, it is the Q-Risk formula that GPs have to follow to decide on CVD risk. If you look at this formula it changed in 2017. Under the cholesterol section it just asks for the Total/HDL ratio. It no longer asks for any of the other cholesterol elements. So the higher the HDL the better the ratio will be. This ratio should be under 5.

https://qrisk.org/2017/

Edited to add the latest Q-Risk formula
https://qrisk.org/three/

 

[JohnEGreen]

Metformin reduces cholesterol levels in particular LDL and total cholesterol.

 

[desidiabulum]

I was told the HDL/LDL ratio was the thing to check, and most of all triglycerides (though I never got an agreed answer on whether these should be tested fasting or not -- results differ enormously if they are -- what have other people been told?).
As for prolonged undiagnosed diabetes causing long-term CVD damage, I was told that by my cardio surgeon, who is one of the top people at Papworth so presumably knows his stuff. It's presumably all a question of degree, and the interaction with genetic, lifestyle and other factors for every individual. The basic message from the surgeon, though, has always been that the single most important way of diabetics keeping a healthy heart is control of BG levels -- so we all agree where it counts (and he always says the ACCORD test was garbage).

 

[lindisfel]

Metformin reduces cholesterol levels in particular LDL and total cholesterol.

Thanks John I didn't know that. Is the reduction significant? regards Derek

 

[Bluetit1802]

I was told the HDL/LDL ratio was the thing to check, and most of all triglycerides (though I never got an agreed answer on whether these should be tested fasting or not -- results differ enormously if they are -- what have other people been told?).

The most important ratio according to many experts is the Trigs/HDL ratio, which in the UK should be under 0.87mmol/l.

If you eat before a Trigs test, especially if there is fat in the meal, your Trigs will be raised as they are out and about in your blood stream doing their job. Although most of us are told not to fast (a NICE recommendation to save surgery waiting lists building up) it is wise to ignore that and fast anyway.

 

[DavidGrahamJones]

Her answer was simply, you have no idea what damage was done before gaining control of BS, and having gained control this damage is most likely irreversible..............................

I should have made it clearer that she was referring to CVD rather than general diabetic complications. We had been discussing the ins and outs of the Q-Risk formula.

Forgive me for poking my nose in.

I beg to differ with your GP, there is a very obvious way of seeing what damage is done. Have a scan.

I was unlucky last year to be admitted to a U.S. hospital who milked my travel insurance up to where I said I didn't think it covered bypass surgery. I'm concerned that had I let them do what they wanted I'd actually be worse off now, especially after my GP, with all the data from the U.S. hospital and after speaking to a UK cardiologist, said I didn't.

Luckily I had 4 tests done, including an echo cardiogram (basically agreed with the one I had the previous year before surgery), a stress MRI scan, and a radionuclide scan. All of which showed nothing worse than a thickened heart wall (described as a bigger bit of heart muscle) and some calcification which was average for a 60 year old, at 64 I wasn't going to worry. The calcification is not to be confused with the clogging caused by a build up of cholesterol and that only gets there because of arteriosclerosis. This also can be spotted in a scan and to some extent the echo cardiogram.

Going back to the calcification, I have read that it can be reversed, there is very definite empirical evidence of reduced calcium deposits in and around certain organs like liver and kidneys where scans have shown reduced calcification. It's not so obvious with blood vessels but can be shown. In the tests that I was reading about they merely supplemented the persons diet with Magnesium. The theory being that it's the Ph of people's blood that causes the problem.