LDL cholesterol in diabetics and statins

[michelle88]

Hi everyone
I'm 43 years old and have been a diabetic for over 10 years now. Since last year, my endocrinologist has been wanting me to take statins because my LDL cholesterol was 4.6 back in February 2021. I managed to lower it to 3.8 in July 2021 (my HDL was 2.5, trigclycerides 0.67, cholesterol-HDL ratio 2.6, total cholesterol 6.4). My bloods were tested again yesterday and I'm waiting for the results, hoping my LDL has further decreased a little.
I refuse to take statins as I've read multiple threads in this forum that they can do more harm than good, plus I don't find my levels to be too bad?! But my endo says that in diabetics, the LDL-protein tends to stay in the blood longer than in non-diabetics, which can cause damage to the blood vessels, that's why statins are a good idea. I would love to hear other opinions on this, as I'm not really convinced.

 

[Grant_Vicat]

Hi everyone
I'm 43 years old and have been a diabetic for over 10 years now. Since last year, my endocrinologist has been wanting me to take statins because my LDL cholesterol was 4.6 back in February 2021. I managed to lower it to 3.8 in July 2021 (my HDL was 2.5, trigclycerides 0.67, cholesterol-HDL ratio 2.6, total cholesterol 6.4). My bloods were tested again yesterday and I'm waiting for the results, hoping my LDL has further decreased a little.
I refuse to take statins as I've read multiple threads in this forum that they can do more harm than good, plus I don't find my levels to be too bad?! But my endo says that in diabetics, the LDL-protein tends to stay in the blood longer than in non-diabetics, which can cause damage to the blood vessels, that's why statins are a good idea. I would love to hear other opinions on this, as I'm not really convinced.

When my father (not diabetic) was rushed to hospital in Versailles over 10 years ago, the consultant enquired what medication
my father was on. On hearing "Statins and Aspirin" the consultant held up his hands and his eyebrows and said, despairingly:
"Ooh, Le gateau Anglais!"

 

[Jo_the_boat]

I believe there is masses of misunderstanding and consequent misinformation regarding cholesterol and statins.
Personally, I would not take a Statin for cholesterol control. BUT.....

You and I have a similar dilemma.
Firstly we both seem to control our cholesterol pretty well. You did lower your LDL in 6 months after all, presumably without the aid of medication? I control mine with diet and exercise. I believe, having read quite a bit about it, that overall there is a bigger problem with low cholesterol than high.

However.... you have been advised to take a statin relating to a specific condition, namely your T1. That is something outside and extra to the general management of cholesterol.
I too have a separate condition for which my specialist advised me to take a Statin, which I do.
In both our cases it is very difficult to go against the advice of a specialist.
But I also know that many HCPs and 'specialists', really know very little about cholesterol and statins. You only have to read some of the stories on here to see that.

I've made my choice. But if I were you, I would read more about statins to understand their relationship with cholesterol control then perhaps go back and discuss it again with your endo. Also perhaps seek a second opinion?
Dr Aseem Malhotra (cardiologist) and Dr Malcolm Kendrick (GP, Author and blogger) are two sources of information that you may find useful.

Sorry this is a bit vague, but I am not a medic. I'm also not a T1, I'm T2. Difficult choice for you. Good luck.

 

[bulkbiker]

(my HDL was 2.5, trigclycerides 0.67

Both really good.

Trig/HDL ratio is thought to be a far more important indicator of future heart problems.
Yours is 0.27 anything sub 0.87 is thought of as excellent.

I'd hazard a guess you have nothing to worry about and am quite envious..

 

[jaywak]

There was another post on here this week I believe discussing the prescribing of statins , apparently your GP gets a cash reward for prescribing them to diabetic patients, so like you i'me a bit concerned as my tests are always in the normal range ( but yes it could be the statins that are keeping me there ) that they are not looking after my welfare but lining their own pockets .

 

[HSSS]

But my endo says that in diabetics, the LDL-protein tends to stay in the blood longer than in non-diabetics, which can cause damage to the blood vessels, that's why statins are a good idea.

Can he support that opinion with science that you can read and investigate for yourself?

 

[Larissima]

I was referred to a lipid clinic because my total cholesterol and LDL were significantly above normal after my carnivore experiment (there was a LOT of cheese involved). There I got the spiel about statins, but also carotid and aortal scans (ultrasound and radio) which showed 0 plaques. The specialist agreed with me that at the time it seemed I did not need the medication after all, especially as I was off the fully carnivore diet (still meat-heavy LC). Lo and behold, my following cholesterol results were much improved. To be fair, I think it was the addition of Berberine as a supplement that drove the numbers down, as much as calming down on the cheese.

 

[Antje77]

But my endo says that in diabetics, the LDL-protein tends to stay in the blood longer than in non-diabetics, which can cause damage to the blood vessels

I would ask them if they can point you to specific studies showing this.
If they can, and the study is sound, I'd be happy to take the statins. If they can't, or the study is flawed, I wouldn't.
It's a lifelong medication and before I take any such thing I would want to have a very good understanding why it would be beneficial for me.

By the way, I've never heard LDL tends to stay in the blood longer in diabetics. This doesn't mean it's not true though of course.

 

[Hotpepper20000]

I still am not convinced that as a woman turning 50 in a few years that lower cholesterol is a benefit.
So it’s not just a debate about statins being beneficial but also is lower cholesterol really healthy?

 

[michelle88]

You did lower your LDL in 6 months after all, presumably without the aid of medication? I control mine with diet and exercise.

Yes I managed to lower my LDL without meds but by incorporating things like barley grass juice powder, fermented black garlic tablets and lemon in my diet, plus more exercise.

 

[HSSS]

Debates on statins on this forum really drive me to despair, there are the same handful of medically unqualified members who repeatedly come on, advise people that there doctors are only prescribing statins because they earn money out of it, and/or your cholesterol numbers aren’t that bad, and/or cholesterol numbers don’t matter, and/or statins are bad for your general health and/or diabetes.

So far as earning money is concerned, a recent debate on here nobody was able to say how much money an individual dr got for prescribing a statin to a patient, what we were able to establish was that there was a pot of money, that was divided between all surgeries depending on how they performed on 60 health measures, one of which was statins .... I can’t see any dr handing out statins just because their practice may get a few pence because they do ..

As to whether statins are good or bad for you, yes those who are anti statin in the same vein as those who are anti vaxers or anti diabetes meds will be able to point to some doctors who say statins, covid vaccines and diabetes meds are bad ... personally I would rather accept the opinion of the majority of health professionals when it comes to statins, rather than some anonymous member of this forum with no claim to have any medical qualifications, just an ability to use google ...

If you are going to base your health decision on the multiple posts on this forum, ignore the same handful of members who contribute to every one to tell how statins are bad and then see what you are left with, but it probably makes more sense to base your decision on the medical expertise of your doctors, rather than anonymous, medically unqualified, members of any Internet forum.

Or use the information you read here to do your own investigations and research so you can have sensible discussions with the dr and make an informed choice rather than blindly accepting whatever you are told - whoever it comes from white coat or not. They are not gods never to be questioned and do not always get it right.

I’m curious how do you manage your type 2?
100% on the drs advice (low fat, regular starchy carbs and medication?)
or perhaps lower carb based on the advice and experience in these same pages you seem to dismiss?

 

[HSSS]

For the benefit of full disclosure, I take a statin, I have done for 17 years, both my parents had high cholesterol, my grandfather died of heart failure in his 40s, my father had a quadruple heart bypass in his 40s, my mother had narrowing of the arteries early in life.

As a result I was advised to have my cholesterol tested when I turned 40, from memory it was 9, diet got it to 7, at that time they wanted it to be 6, I am now at 4. I am unaware of any side effects, 16 years after I started taking it and many stones later I was diagnosed as type 2, I don’t suppose that has much to do with the statins but I guess someone quoting stats will use me as an example of statin users becoming diabetic.

So you have some very specific family history that potentially alters your risk compared to someone without such history - which could be dietary/lifestyle habits passed along as well as genetics of course. All the more reason for personalised and informed decisions rather than blanket prescribing wouldn’t you say?

And of course none of us can say that statins caused your type 2. Can you be certain it didn’t contribute though?

 

[Jo_the_boat]

For the benefit of full disclosure, I take a statin, I have done for 17 years, both my parents had high cholesterol, my grandfather died of heart failure in his 40s, my father had a quadruple heart bypass in his 40s, my mother had narrowing of the arteries early in life.

As a result I was advised to have my cholesterol tested when I turned 40, from memory it was 9, diet got it to 7, at that time they wanted it to be 6, I am now at 4. I am unaware of any side effects, 16 years after I started taking it and many stones later I was diagnosed as type 2, I don’t suppose that has much to do with the statins but I guess someone quoting stats will use me as an example of statin users becoming diabetic.

That explains your unbiased opinion! I'm not surprised you take what you can with a family history like that. I would have a different view too. As I said above I too take a Statin for another reason.
But, the fact is that, regarding Statins, opinions are changing for those with no real underlying health condition. I attach the links to two articles from two different doctors coming at the debate from differing angles.
Things need to change and they will with open debate.
Fifty years ago smoking was part of a happy, healthy lifestyle.
The protocol for dealing with heart attack victims used to be 6-weeks bed rest. Then along came a doctor who said that people should get up and about as soon as possible. In the early days I believe his staff ridiculed him and even stood to gave him the Nazi salute. Now that new protocol is credited with saving 1000s of lives.

Those links:

https://drmalcolmkendrick.org/2020/08/05/cholesterol-lowering-has-no-impact/

https://sebastianrushworth.com/2022/04/14/what-defines-a-good-drug/

 

[jaywak]

My wife was classed as asthmatic and all her childhood she was given inhalers , i think when she was 40 ish her DR said he didn't think she needed them , she's now in her 60s and hasn't needed them since , it just shows that they can make mistakes and sometimes we do have to question them !

 

[Antje77]

Can we please stay on topic.
Someone has asked a question relating to her own situation, let's try to reply to that.

 

[Resurgam]

My cholesterol levels decreased after eating low carb - I had been told to take Atorvastatin but it was frightening to realise that my memory had been affected. I lost the car in the supermarket car park, wandered around using the key to locate it, and then realised that I'd done the Christmas shop already and left the stuff in the car.
I could no longer sing from memory, and had forgotten so many things - I still can't remember how to play guitar, but quite a lot has come back over the years.
It was after only 5 weeks taking the tablets that I binned them.

 

[NicoleC1971]

Hi everyone
I'm 43 years old and have been a diabetic for over 10 years now. Since last year, my endocrinologist has been wanting me to take statins because my LDL cholesterol was 4.6 back in February 2021. I managed to lower it to 3.8 in July 2021 (my HDL was 2.5, trigclycerides 0.67, cholesterol-HDL ratio 2.6, total cholesterol 6.4). My bloods were tested again yesterday and I'm waiting for the results, hoping my LDL has further decreased a little.
I refuse to take statins as I've read multiple threads in this forum that they can do more harm than good, plus I don't find my levels to be too bad?! But my endo says that in diabetics, the LDL-protein tends to stay in the blood longer than in non-diabetics, which can cause damage to the blood vessels, that's why statins are a good idea. I would love to hear other opinions on this, as I'm not really convinced.

So I am not into statins either on the basis that like you I am female with a good hdl/trig ratio but at LDL that triggers a suggestion of a stain automatically so naturally I am also worried as to whether I need to reduce my higher ldl.
I am in to low carb/real food so have stumbled across Aseem Malhotra, Ivor Cummins and the best explanation for all of this in this book The Clot Thickens by Dr Malcolm Kendrick which is a clear refutation of the lipid heat hypothesis.

I think it is important to know that as diabetics we do cause damage to our endothelium and (layer of cells that line our arteries) just because we have higher blood sugars than normal. If you also smoked, had sickle cell anaemia, snorted cocaine and lived in a polluted city road you would be doing damage on top of this.
Then the question has to be around what difference LDL makes because there's no evidence that reducing LDL particles makes a difference possibly because there isn't a mechanistically plausible way that these LDL particles can get through the arterial wall to cause further damage as the lipid heart theory contends.
As I've said before I've got a bias against statins having understood that they have a low chance of preventing my having a heart attack and won't change how long I live. I bet if you ask your endo he won't know the Number Needed To Treat (to prevent a heart attack) nor the number of extra days you get to live (Zero if you don't have proven heart disease and 4 days if you do apparently).
In this situation I am focussing my efforts on keeping blood sugars in a good range and all the other lifestyle things that reduce my risk more than statins ever will (exercise, sleep, managing stress etc.)! I can't see a benefit to taking a statin.

 

[michelle88]

To be fair, I think it was the addition of Berberine as a supplement that drove the numbers down, as much as calming down on the cheese.

I take Berberine as well, although only in the weeks before my period because I seem to be more insulin resistant then. Do you take it every day?

 

[Larissima]

I take Berberine as well, although only in the weeks before my period because I seem to be more insulin resistant then. Do you take it every day?

I take it every day, but not all year round. I buy a 2-months supply, finish it, then have a break (usually a few months, sometimes less, once over a year) before getting a new bottle. I take a lot of supplements on such an irregular schedule, I could not afford to take everything all the time (nor be able to swallow all the capsules, LOL!)

 

[michelle88]

Can he support that opinion with science that you can read and investigate for yourself?

I should have asked her that! But I tend to find it so difficult to discuss with healthcare specialists without wanting to come across as knowing better than they do. I don't, but I don't see them as gods in white either. Have had enough experience where I was right to be sceptical.