Type 2 Dr Review And Chloesterol

mazza 2

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248
Type of diabetes
Type 2
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Diet only
Hi everyone, I've just had my doctor's review since receiving my latest blood results which are as follows:

HBA1C - 46
Serum Cholesterol: 4.6
Serum triglycerides: 1.13
Serum HDL: 1.43
NOn HDL: 3.2
Calculated LDL: 2.7
Ratio: 3.2
I was quite pleased with the results and asked if I could reduce my metformin as my levels were now in pre-diabetic range. He's reply was that I am still diabetic and always will be and although I have done very well, I am just a well diet controlled diabetic. I agreed with the fact I will always be diabetic but at this moment in time, I have managed to get into pre-diabetic territory and therefore it will hopefully prevent certain health problems associated with diabetes. I am currently taking 2000mg of metformin a day and he said I will have to continue that for the foreseeable future. The other thing is he still wants me to take statins to which I replied "No". I said my cholesterol levels have improved but he said he want it 4 or under. He said my LDL was too high. I appreciate you are not able to give medical advice but I wanted to ask if anyone had any views as to whether I should take statins. I said that I will try to reduce the level in 3 months time and he agreed to re-test then. Considering my overall cholesterol was 6.4 in January, I thought this would be sufficient to keep me off statins. Has anyone any advice as to how I can lower them to 4? Thanks to everyone for your ongoing advice.
 

Indy51

Expert
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5,540
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Ask him to show you medical research that proves that low cholesterol is healthy for women.
If I were you, I'd be finding a new doctor. The guy sounds like a box ticker to me. There is such a thing as informed consent. Telling somebody they should do something without discussion is not "informed".
 

Rachox

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Your triglyceride level and your ratio are both normal. GPs really need to ignore the total. My total is now at 6.4 but my ratios are normal so I have declined Statins. My GP respects my decision but has always said he has to ask.
As for the Metformin, again it’s your choice. I recently reduced mine for 3 tablets a day to 2 but I did wait until I had been in the non diabetic range for several readings before I brought the subject up with my GP. Again it’s your decision but always good to have your health team in agreement.
 
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Resurgam

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'just' a well controlled diabetic - master of understatement they are.
 

Guzzler

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Health Care Professionals are there to advise not to opine. Read up on cholesterol and then make a decision as to whether your numbers and medical history warrant taking a statin for the rest of your life. As to Metformin, the stats are there and have been for a very long time, again you need to read up and make up your own mind. You may end up in agreement with your GP, who knows?
 

donnellysdogs

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Ask him to show you medical research that proves that low cholesterol is healthy for women.
If I were you, I'd be finding a new doctor. The guy sounds like a box ticker to me. There is such a thing as informed consent. Telling somebody they should do something without discussion is not "informed".

Couldn’t have put it better!!
 
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zand

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A couple of years ago I read that there has never been any clinical evidence to show that statins are beneficial to women at all, regardless of what their cholesterol figures are. Your own results are really good. There's no way I would take statins if I were you.

Dr Uffe Ravnskov and Dr Malcolm Kendrick are also good on why we should not take statins.

re Metformin. My own GP won't prescribe it for me now as my last HbA1c was similar to yours and I was never on more than 1000mg daily. Metformin does have other protective qualities though so unless it is causing you any problems I wouldn't rush to be taken off that. Just my opinion of course. :)
 

Pipp

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Messages
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Type of diabetes
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Hi, @mazza 2

Well done on your improved results. Though HbA1c is still in pre-diabetes range.
Regarding the Metformin.
When I first managed to get HbA1c scores below even the pre-diabetes levels I chose to come off Metformin. My GP suggested I should reconsider, as Metformin helps manage insulin resistance, and as I still had weight to lose it could be beneficial in maintaining good BG levels. I refused, as I wanted to be on as few meds as possible. I have to say, I wish I had taken notice, as there has been a gradual increase in BG over the last year or two, and a recent HbA1c of 52 had me pleading ror the Metformin again.

https://www.diabetesselfmanagement.com/blog/metformin-for-prediabetes/
 

lessci

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1,024
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It's your choice - your GP can prescribe the meds, but you don't have to collect the prescription or take them. Just make sure that it's an informed choice
 

Mr_Pot

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It's your choice - your GP can prescribe the meds, but you don't have to collect the prescription or take them. Just make sure that it's an informed choice
The problem with that idea is that your record will show you are taking the medication which could influence a doctor's diagnosis or action in the future.
 

Daibell

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With regard to statins, NICE defines the total of 4 for diabetics and 5 for non-diabetic. The number of 4 is just plucked out of thin air. As others have said anyway, it's the ratios that matter and Women need to worry less as well. Yes, NHS box-ticking. Do read Malcolm Kendrick's books.
 
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NoCrbs4Me

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When my HbA1c got down to normal levels a doctor told me to stop the metformin. I did and I didn't see any changes in my blood glucose levels. Metformin really has a very modest influence on blood glucose levels compared to the effect of lowering carb intake. A doctor can't force you to take any meds, as far as I'm aware.
 
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mazza 2

Well-Known Member
Messages
248
Type of diabetes
Type 2
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Diet only
Health Care Professionals are there to advise not to opine. Read up on cholesterol and then make a decision as to whether your numbers and medical history warrant taking a statin for the rest of your life. As to Metformin, the stats are there and have been for a very long time, again you need to read up and make up your own mind. You may end up in agreement with your GP, who knows?
I've read quite a lot about cholesterol and there is so much conflicting advice, but I'm happy with my levels at this moment in time. So, unless things should drastically change, I will not be taking statins. As for metformin, I've read good and bad things about them. If they help, I'm happy to take them, but my thought process was that when diagnosed my A1C was 76 and I was put on 4 tablets a day, it's now 46 and I'm still on 4 tablets a day. Is it possible to take to many for your bodies needs? I don't pretend to know all the answers but it can be difficult to make such important decisions about what's best for your health when there is so much conflicting advice.
 

mazza 2

Well-Known Member
Messages
248
Type of diabetes
Type 2
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It's your choice - your GP can prescribe the meds, but you don't have to collect the prescription or take them. Just make sure that it's an informed choice
Quite correct. That's what my doctor said to me. I haven't collected the prescription for the statins, so he knows I'm not taking them. I'm due to see my DN nurse on Monday so it will be interesting to see what she thinks!!!
 

mazza 2

Well-Known Member
Messages
248
Type of diabetes
Type 2
Treatment type
Diet only
Hi, @mazza 2

Well done on your improved results. Though HbA1c is still in pre-diabetes range.
Regarding the Metformin.
When I first managed to get HbA1c scores below even the pre-diabetes levels I chose to come off Metformin. My GP suggested I should reconsider, as Metformin helps manage insulin resistance, and as I still had weight to lose it could be beneficial in maintaining good BG levels. I refused, as I wanted to be on as few meds as possible. I have to say, I wish I had taken notice, as there has been a gradual increase in BG over the last year or two, and a recent HbA1c of 52 had me pleading ror the Metformin again.

https://www.diabetesselfmanagement.com/blog/metformin-for-prediabetes/
According to my doctor a diabetic can't be a pre-diabetic. They are always diabetic ( time for a more informed doctor). Currently, I am underweight, that is why I questioned if I should still be on 2000mg per day. I have read that metformin can reduce appetite which I really don't need to do. Also, I'm sure I read on another forum that taking too much metformin for your body weight can cause lactic acidosis. Not sure if that's true, but don't want anything else going wrong.
 

Guzzler

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I've read quite a lot about cholesterol and there is so much conflicting advice, but I'm happy with my levels at this moment in time. So, unless things should drastically change, I will not be taking statins. As for metformin, I've read good and bad things about them. If they help, I'm happy to take them, but my thought process was that when diagnosed my A1C was 76 and I was put on 4 tablets a day, it's now 46 and I'm still on 4 tablets a day. Is it possible to take to many for your bodies needs? I don't pretend to know all the answers but it can be difficult to make such important decisions about what's best for your health when there is so much conflicting advice.

The only negative thing I've heard on Met is that it can cause malabsorption of B12 but as to dosage and timescale (always described as 'long term use' though nowhere have I seen how long is long term). It is not an easy decision to make but for me it sometimes comes right down to quality of life. I took a statin for one week and had side effects so I discontinued, I've had no side effects from Met so I'm happy to take them but have already decided to discontinue by the end of the year as long as my Diabetes remains well managed and this is purely because I would like to reduce the number of medications that I take.
 

Pipp

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According to my doctor a diabetic can't be a pre-diabetic. They are always diabetic ( time for a more informed doctor). Currently, I am underweight, that is why I questioned if I should still be on 2000mg per day. I have read that metformin can reduce appetite which I really don't need to do. Also, I'm sure I read on another forum that taking too much metformin for your body weight can cause lactic acidosis. Not sure if that's true, but don't want anything else going wrong.
Precisely the reason why we need to do our own research and apply to our own, unique circumstances.
It can't help if you don't feel your GP is being helpful, but some of them do not like it when patients want to be in control of their own health. I set out my stall early on when one GP wanted to bully me over statins. She stated that I was definitely going to have a heart attack or stroke if I didn't do as she said. My response was that I know my QRISK score, and that showed I less likely to have a cardiac event than have one, and I had done a cost/ benefit analysis, and so was declining. I then made it clear that I am happy to discuss health issues with them and be advised, but I own my health and I own the decisions I make too.

Good luck, whatever you decide.
 

Guzzler

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This short, less than five minutes, segment on the news by Aseem Malhotra should be enough for anyone to start asking questions about their own treatment re statins. The data held at Oxford that Dr. Malhotra alludes to is that held by Rory Collins (or rather it is held by his research sponsors).