Question re cholesterol

[Bluetit1802]

Also once you have been diagnosed Type 2 you will always "fail" the Q-Risk score as being diagnosed adds I think 7-8% onto your score even if your HbA1c is below Type 2 levels (there is nowhere to put your HbA1c).

And probably know very little about the mechanisms of cholesterol...

And don't forget, your Q risk score goes up every birthday! Once you get to 70 you have no chance! Mine will go up by 1.4% next birthday.

My score comes down by almost half if I take diabetes out of the equation, and the smoking bit makes less difference than the diabetes.

Post codes also make a difference.

https://qrisk.org/2017/index.php

 

[Bluetit1802]

Not all Dr's do @Bluetit1802

After a health scare some years ago (at first it was thought it was CVD related but turned out it wasn't) I was given a prescription for a statin due to my age and longevity with type 1, when chatting to my regular gp he dismissed the suggestion that I should take statins as I had excellent cholesterol levels (TC was 4.3 at the time), I exercised regularly and ate a healthy diet, he said we could look at things again in 5 years time, it's roundabout that time now but statin's have not been mentioned since.

I think that 5 years ago the target Total was 5. (Could be wrong with the timing). You were under that, so yes if that was the case, your cholesterol was fine at the time. But even NICE don't recommend a total target these days. As I said, it is the total/HDL ratio that is to be looked at. (Target is under 5) Mine is 2.5 but my total is 6.1.

 

[Pinkorchid]

thanks- when he goes back to have the repeat blood tests I'll make sure that he doesn't eat breakfast beforehand. I did think it seemed a little strange not to do a fasting one. Best to get everything on your side that you can

I think we have to fast when kidney and liver function are tested as well as cholesterol and glucose levels I am always told to fast for 12 hours for my blood tests

 

[bulkbiker]

And don't forget, your Q risk score goes up every birthday! Once you get to 70 you have no chance! Mine will go up by 1.4% next birthday.

My score comes down by almost half if I take diabetes out of the equation, and the smoking bit makes less difference than the diabetes.

Post codes also make a difference.

https://qrisk.org/2017/index.php

hmm so do we think its "fixed" certainly sounds that way!

 

[lindisfel]

The problem there is that doctors take those figures as actual targets to be met and maintained, not as a guide. Total over 4 and statins get pushed on you, even if a large part of that total happens to be good cholesterol.

NICE pathway says that among other things, doctors should perform the Q-Risk formula to assess CVD risk. This formula only asks for the Total/HDL ratio. Nothing else about cholesterol. It used to ask for LDL and triglycerides, but no longer.

Don't these characters also recommend the food industry sponsored, "eat well plate"?

 

[lindisfel]

Worth reading: The cholesterol and calorie hypotheses are both dead — it is time to focus on the real culprit: insulin resistance

 

[noblehead]

I think that 5 years ago the target Total was 5. (Could be wrong with the timing). You were under that, so yes if that was the case, your cholesterol was fine at the time. But even NICE don't recommend a total target these days. As I said, it is the total/HDL ratio that is to be looked at. (Target is under 5) Mine is 2.5 but my total is 6.1.

I've just checked and my discussion with the gp was 2011............how time flies.

The TC figure for people with diabetes was 4, remember it being mentioned during my hospital stay, and (as one would expect) the figure was a topic of discussion on the forum, not sure when it changed from 5 to 4.

 

[Sam50]

To calculate the ratio, divide his trigs by his HDL. His ratio is 2.6, so that needs attention. However, as he didn't fast for the test, his trigs were most likely higher than they should be. When we eat the trigs come out to play and swim about in our blood stream doing their job. Hence, a non-fasting test will show a high level. Next time, I suggest he fasts (water only) and no alcohol the night before. He will probably be told fasting isn't necessary, but to get an accurate trigs level. it is necessary. Just ignore them and fast anyway. I always do.

2.3 divided by 3.3 is 0.69 for a ratio ? does that sound correct ?

 

[Sam50]

The problem there is that doctors take those figures as actual targets to be met and maintained, not as a guide. Total over 4 and statins get pushed on you, even if a large part of that total happens to be good cholesterol.

NICE pathway says that among other things, doctors should perform the Q-Risk formula to assess CVD risk. This formula only asks for the Total/HDL ratio. Nothing else about cholesterol. It used to ask for LDL and triglycerides, but no longer.

It's certainly a learning curve and I can't understand why if your sugars/BP/cholesterol etc are all well managed why it is not okay to be in the 'normal' range for those things ? Why do diabetics have to be lower on all counts, especially if being on meds makes those targets difficult to achieve/maintain ?

I had a really good read of Hubby's blood test reports and the cholesterol one ( which stated that he was a newly diagnosed T2) actually stated 'no further action needed' so I really feel that the nurse pushing statins is just meeting our surgery's agenda. Just feeling a tad cynical here.
Read an interesting report recently concerning statins ( forget which particular one) and it said that it shouldn't be given to people over the age of 60 as it increased blood sugars by up to 50%.

and yet they push them on diabetics ?! crazy world

 

[Bluetit1802]

2.3 divided by 3.3 is 0.69 for a ratio ? does that sound correct ?

No. You have used the LDL figure.

Trigs = 2.3
HDL = 0.89

Ratio = 2.3/0.89 = 2.6

 

[Bluetit1802]

I had a really good read of Hubby's blood test reports

I don't know if you are a data freak or not, but what I did before my test results came on-line was to copy out all the results of all tests for all markers to a spread sheet. I kept this up to date test after test. I could see at a glance where I was stable, improving or deteriorating. It was easier than searching back through many print outs. No need to do this now. It has all been done for me on-line, including graphs.

 

[Sam50]

No. You have used the LDL figure.

Trigs = 2.3
HDL = 0.89

Ratio = 2.3/0.89 = 2.6

apologies and thank you for putting me right. I've looked at so many figures and stats in the past few weeks that my head is spinning. Will make a note of that x

 

[Sam50]

I don't know if you are a data freak or not, but what I did before my test results came on-line was to copy out all the results of all tests for all markers to a spread sheet. I kept this up to date test after test. I could see at a glance where I was stable, improving or deteriorating. It was easier than searching back through many print outs. No need to do this now. It has all been done for me on-line, including graphs.

That is a very sensible idea. I think I will do likewise as we can't access medical info online and that would make it easier to interpret.

Yes had far too many run-ins with management over salary errors in the past...I appreciate facts on a spreadsheet !

 

[Bluebirdsinging]

Any advice on low carb sweet snacks?

 

[bulkbiker]

Any advice on low carb sweet snacks?

Apart from best avoided you mean?