Confused after visit to diabetic nurse

[Gary1205]

Just come from my first three month visit to the DN having been diagnosed just over three months ago. She complimented me on my HbA1c down from 98 to 47 saying she had never seen a reduction like it before. I have also now lost 2 stone 10lbs since diagnosis and still losing, and my cholesterol also down, in fact my good cholesterol slightly too low which she put down to my weight loss. Cholesterol overall 2.6 down from 7.1. So was hoping to come off the statins but she suggested I would be on those for life now, be disappointed if that is right. Is this correct?
Also reducing my metformin 500 down from one twice a day(breakfast and evening) to once a day and if things continue might even come off them in three months time.
Had a number of questions which she did not seem to want to answer, but when I asked what time of day to take this one metformin she referred to her book then her computer and did not seem at all sure before finally telling me to take it with my breakfast. I picked up a repeat prescription and discussed with the pharmacist who suggested I would be better taking my one a day with my evening meal(generally my main meal of the day). Totally confused and do not know what to do for the best. Appreciate any thoughts with regards to the statins(will I be on them for life?) and best time to take metformin.
Should have come out of there pleased given my progress but have left feeling very down.

Gary

 

[Bluetit1802]

Hello Gary,

I can't answer any questions about Metformin as I am type 2 diet only. However, your total cholesterol is low. Do you know the breakdown? (LDL/HDL/Triglycerides?) These are what you should be looking at, especially the trigs and HDL.

Telling you that you will be on statins for life is just plain silly. You need to read round this forum and research the advantages and disadvantages of taking them, then make your own mind up. No-one can force you to take them. Maybe a word with your GP rather than the nurse? Low cholesterol is just as harmful as high cholesterol.

 

[Ruth B]

Congratulations on the results they look fantastic for 3 months.

When I was on an odd number of Metformin I was always told to take the higher amount in a morning (at one a day take it with breakfast, on 3 a day 1 with evening meal and 2 with breakfast), statins were always take one in the evening. If there is so much confusion it makes me wonder if it really matters.

If your cholesterol remains low I would push to reduce the statins in view of coming off them, sometimes a doctor will be more willing to accept a reduction to see how it goes rather than coming straight off a medication.

 

[Gary1205]

Thank you both for the replies. I am curently on Altoravastatin 20mg one a day. I am afraid this morning became a bit of blur insofar as the results, but do remember 2.6 for total and the nurse telling me good cholesterol was too low. I maybe doing her an injustice but almost felt like she wanted to move me along to see the next person as a few questions I had given it is early days went unanswered. To be fair she did praise me up with the way I have dealt with my diagnosis and am obviously taking my condition seriously. But as I have said to her, I have seen first hand with my late father (type 1) the complications that can arise if I do not look after myself, so that is what I intend to do.
Gary

 

[Bluetit1802]

If you ring your surgery and ask for a print out of the test results you should get them without a problem. If the receptionist is awkward about it, ask to speak to your nurse and ask her the same question. You are entitled to these print outs and will find them invaluable down the line when you want to compare them with future results. You will be having these tests regularly for the rest of your life. I copy all mine to an excel file so I can keep a look out for upward/downward/sideways trends.

I believe there is an Altoravastatin 10mg.

 

[NoCrbs4Me]

Good work! As for metformin timing, I don't think it matters too much as it has chronic effects, not acute. In other words it doesn't have a short term affect on blood glucose levels, but rather it's long term. That's why they say it takes a few weeks of taking it before you will see any change. However, it's probably a good idea to take it at the same time every day.

 

[Gary1205]

Thanks for the replies. Have to be honest and say that visit has left me feeling rather despondent and why I am a bothering. My aim when diagnosed was to put myself in a position where I could manage things without medication, which clearly I have taken great strides towards diabetes wise. Maybe it has not been explained to me properly re the statins, but cannot help feeling the reduction in the cholesterol is just down to them surely has got quite a bit to do with me changing my ways, if it hasn't left me feeling what's the point, might just as well go back to my old ways and let the meds do their stuff if I cannot come off of them. To my logic (I am no expert and could be wrong), no doubt if I came off there would be an increase but surely not back to old levels given I have clearly shown I am watching my diet and getting more exercise, am I being too simplistic?
Gary

 

[DeejayR]

Hello Gary ... well done on reducing your blood sugar levels so significantly.
I decided to stop taking statins even though my cholesterol was over 5 at the last count. It felt a bit like taking a space helmet off when the "experts" are saying there's no air. However, my GP agreed I could give it a go since I seem to be very well in all other respects.
I also have a mild heart condition but eat loads of fat. Ho hum.
I will never know exactly what's going on inside me but it does seem from this forum that often, if we control our BS levels well, other problems become less or disappear.
I'll be interested to hear what you decide.

 

[Brunneria]

I'm no medical professional, but your nurse sounds like an ignorant idiot.

There are many T2s who manage to come off medication and manage by diet and exercise alone. Some of them post on this forum. Giving someone a drug (statin) 'for life' without bothering to investigate whether they still need it is simply bad practice.

Have a google for the risks of too low cholesterol (they are as bad as too high), and then discuss it with your doc - since your nurse clearly doesn't understand the basics.

Maybe up your oily fish intake, add nuts, chia seeds or supplement with Omega 3s to increase your HDL (the healthy cholestrol)

There is some evidence that Metformin (at a suitable dose) may have long term benefits to life expectancy, so maybe have a look for that info too. I agree that metformin's effects take 3 weeks or so to kick in, and work in the background, rather than controlling BG on a meal by meal basis, so time of day is irrelevant. Maybe just pick a time and make it habitual?

Congratulations on your hugely impressive A1c results.
She should have been celebrating with you, congratulating you and asking to learn how you did it, instead of parroting dogma.

 

[Ruth B]

High cholesterol is in my family so when mine was first checked and came back with a result of 7.7 I wasn't surprised. I was put on 40mg of Simvastatin which brought it down to high 5s low 6s, It was then changed to 40mg Atorvastatin which seemed to hold it at 5.7 - 5.8. My doctor did say that we could increase the statins further but she didn't think the side effects of that high a dose were worth the negligible benefits so it stayed at 40mg.

Since April last year I have been working at controlling the diabetes and moved to a diet that is reduced carbs but includes more full fat products. I lost about 3 stone in weight last year on that diet and in January was quite please that it hadn't seemed to effect my cholesterol, still at 5.8. Yesterday I got the results of my 6 month check up and while the weight and sugars have remained fairly constant my cholesterol has dropped to 4.8. So it is obvious that statins aren't the whole answer and a low fat diet isn't either.

I don't think anyone really knows just what effects our cholesterol levels and medical opinions are constantly changing. I also think that our bodies may take longer to settle to altered diet or medication than many HCP realise. With my family history I doubt I will ever come off statins, but if you feel you want to then push your doctor into letting you try and don't let them push you back on to them too quickly. in the end its your body and while a doctor can advise you of the risks it is your choice and you will have to face the concequences not the doctor.

 

[Bluetit1802]

Thanks for the replies. Have to be honest and say that visit has left me feeling rather despondent and why I am a bothering. My aim when diagnosed was to put myself in a position where I could manage things without medication, which clearly I have taken great strides towards diabetes wise. Maybe it has not been explained to me properly re the statins, but cannot help feeling the reduction in the cholesterol is just down to them surely has got quite a bit to do with me changing my ways, if it hasn't left me feeling what's the point, might just as well go back to my old ways and let the meds do their stuff if I cannot come off of them. To my logic (I am no expert and could be wrong), no doubt if I came off there would be an increase but surely not back to old levels given I have clearly shown I am watching my diet and getting more exercise, am I being too simplistic?
Gary

No need for despondency Gary. You are doing brilliantly.

My personal experience with statins is this. When I was diagnosed in January 2014 I was put on statins "because we put all diabetics on statins". My total cholesterol was 6.1. (HDL 1.56, LDL 4.0, Trigs 1.25)

I took the statins but then read up about cholesterol, statins, diabetes and so forth. I took myself off the statins after a month or two and told the GP later. She was not happy.

Since then I have had 4 blood tests and followed a low carb/high fat diet, and reduced my BMI from 30 to 20. My total cholesterol dropped and has remained at a steady 5.3, and my breakdown bits have improved test by test. (currently: HDL 2.4, LDL 2.6, Trigs 0.6). These results are excellent, and all done by diet with a little added exercise. My GP is now happy.

It can be done, although it may not work for everyone.

 

[Gary1205]

Thanks for those responses. I agree that I should be feeling pleased with myself, but really feel the stuffing got knocked out of me yesterday, albeit pleased I am going in the right direction towards coming off the metformin. On that front decided to take it with breakfast per the DN, as I am stuck with her for the moment better do it her way.
Not been at all happy with my practice but no other in my area, so cannot change. february went to GP because I had my suspicions given the symptoms. Had a blood test which at the time did not mean anything to me, they just told me it was elevated, however no rush to see DN two and half weeks later first appointment, so thought maybe as no rush was going to be told a warning shot if I don't change my ways, DN even said on the telephone not to change anything until I saw her, so carried on having sugar and all the bad things. At that appointment she told me I was T2 and come back in two weeks when she would put me on meds and gave me a photocopy of the eatwell plate did not really answer any questions, basically told me to look things up on the internet. So a whole month passed before I even got onto meds after the blood test, by which had now started changing my ways and already lost half a stone, because of this she contemplated not putting me on anything at that time but changed her mind. Again not very helpful with questions at the second appointment.
Attended an Xpert course which I found very informative and this has formed the basis of what I am doing leading to me managing my condition.
GP surgery messed up on a urine sample so had to provide another, did not sign my exemption form before sending it off. So when I eventually got it, it was dated after my first prescription so initially could not get a refund, had to fight hard but eventually got it backdated so I got the refund. Now yesterday again she did not fill me with confidence not knowing when to take the one metformin and seemed as I say to want to shoo me out to see the next person and did not want to answer my questions, I had four written down in relation to the management of my condition so I went along prepared as it were, so these went unanswered. To be honest I am totally exasperated with the whole thing and feel I have badly dealt with, but stuck with this practice even though I really do not have any confidence in it, particularly the DN, already dreading the thought of going back in three months time. Feel I am in the hands of people who are not filling me with confidence. Would not be quite so bad if I felt I could get them to explain things (such as why they think I will be on statins for life) but just feel in the dark and get on with it myself as best I can. Just feel I am doing well inspite of them not because of them. At least I know I've got understanding people to turn to here.

 

[Tkly]

My own experience with statins was very negative, major memory loss, violent muscle cramps, things got to where my wife thought I was getting early onset Altzimers. I reserched statins and found that these were common side effects so I stopped them there and then within two weeks my memory had returned to normal (what ever that is ). My Doc didnt notice for a year and I refused to take them again the doc was not happy. I am now on fenofibrate. the choice of what medication you put in YOUR body is entirely up to you doctor and Nurses can only advise you according to what they have learned (some of them can be well behind the times and need a refresher course). Have you been to the diabetic department of your local hospital they are often more up to date than DN's

 

[rekeenon]

Do not let them convince you to stay on statins US FDA reports are coming out that statins can cause type 2, plus many other health conditions Joint pain, foggy head (because your brain needs cholesterol, eye cadarats, which a friend of mine did not have before taking statins. Please read about the dangers of statins and how the drug companies have doctors on statins whether they had low LDL OR NOT. It should always be a three to five month period of trying to change your diet before starting a statin. A low does is 5mg and will still start some of the side effects. It is a very harmful drug that is being widly overused for profit