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Diabetes and high cholesterol

Discussion in 'Ask A Question' started by rosqho, Dec 10, 2008.

  1. rosqho

    rosqho · Member

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    Anybody give me any tips on how to reduce high cholestrol by diet only - have been prescibed Simvastatin but after having read the possible side effects I'm not sure I want to tale them! Type 2, controlling bs (7.4) by diet only but now told cholesterol levels ( HDL1.6, LFL 4.9) too high. Diagnosed March 08, have lost 20kg but seem to be static now. Any help, advise and tips would be welcome. :?
     
  2. IanD

    IanD Type 2 · Well-Known Member

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    On diagnosis 8 years ago my chol was 7.6. Adding benecol/flora pro-v & oat bran to my low sugar/low fat/low salt/complex carbs diet reduced it to the low 5s.

    Simvastatin caused muscle pains, as did niacin. Niacin also increased by BS readings.

    A year ago my total chol was 5.4. I started reduced carb diet in May this year. My chol is 4.4 at the Nov check. That is in fact a reduction of 40% (7.6 to 4.4) by diet alone.

    Hope that helps.
     
  3. Katharine

    Katharine · Well-Known Member

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    The diabetes guidelines are pushing for total cholesterol below 4 and LDLs below 2. This is usually only possible if you go on high doses of statins.

    The thing is that total cholesterol and LDL have little if anything to do with cardiovascular mortality.

    Much more important are:

    normalising blood sugars
    normalising blood pressure
    avoiding kidney damage/proteinuria
    not smoking
    normalising HDL and triglycerides
    exercising
    normalising weight esp waistline.
    reducing stress

    All of the above can be achieved by not smoking, exercising esp interval / resistance training, sorting out things that contribute to personal stress or unhappiness and following a restricted carbohydrate diet.
     
  4. phoenix

    phoenix Type 1 · Expert

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    I'm positive lowering of overall BG levels + statins reduced my lipids profile dramatically but how do you separate the 2 ? For me (I think) statins were important to reduce my cholesterol and I did not suffer any obvious ill effect from taking them. However, I have been able to keep them at a fairly low level through diet and reduced BG levels.

    When I was diagnosed, I had an horendous lipid profile. From the description it sounds as if my blood was thick and gloopy. I took statins, and started insulin. On dietitians advice I reduced saturated and increased good fats, (more oil in salad dressings , oily fish twice a week, avocados) plus much more veg and fruit in diet. I did not reduce overall carbs (I do use insulin) but selected them more carefully and measured their glycemic effect. (whole mixed grain bread, wholegrain rice and pasta etc). I already exercised but probably increased it. The results were a dramatic change in lipid profile.
    More recently I tend to take the stain ( a lower dose from before) very infrequently, although it is still prescribed. The LDL has risen but so has the HDL so the ratio is better. My diet has remained the same, as have exercise levels.

    April 2005 / June 2005 (40 mg simvastatin) / March 2008
    + controlled BG (occasional
    20mg statin)

    fasting BG: 20.85mmol / HBA1c 6% / HBA1c 4.9%
    plasma: opalescent / clear straw coloured / clear straw col
    triglycerides: 3.19mmol / 1.45 mmol / 0.73mmol
    total chol : 8.3mmol / 3.99mmol / 4.66mmol
    HDL : 1.18mmol / 1.23mmol / 1.59mmol
    LDL : 5.75mmol / 2.10mmol / 2.73mmol

    total Ch/HDL: 7.06mmol / 3.22mmol / 2.91mmol
    ratio

    Sorry, my fairly clear chart didn't survive on posting :(
     
  5. hanadr

    hanadr · Expert

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    There's quite a lot of evidence that a low carb diet lowers LDL cholesterol and raises HDL cholesterol( which is what we need, but as Katharine has already written, there's no evidence on how much if any effect it has on the incidence of cardiovascular disease.)
     
  6. phoenix

    phoenix Type 1 · Expert

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    I'm not sure thats the case, there is plenty of evidence, just that its often contrary! see bandolier http://www.medicine.ox.ac.uk/bandolier/band66/b66-2.html

     
  7. Trinkwasser

    Trinkwasser · Well-Known Member

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    In general (with a fair degree of individual/genetic variation) reducing carbs can be guaranteed to bang down your trigs. In the absence of high levels of trigs the balance between HDL and LDL changes for the better - and the LDL molecules become fluffier and more benign (bearing in mind that LDL is an important substrate for the manufacture of hormones and many other important chemicals, some trials have shown a distinct J curve from reducing it too far)

    It is often the case that LDL *increases* on a reduced carb diet - but this may be outweighed by the increase in HDL and the major improvement in trigs/HDL ratio. Statins focus almost exclusively on LDL reduction.

    I was actually going to do a trial of dropping my statin for a month prior to my next bloods purely to see how much improvement was dietary and how much from the drug, however time passes and I found I had missed my Medication Review. I asked my GP if I could do it in January instead and she told me in view of my major and continuing improvements there was no need for another one for another six months, so I'm afraid this experiment will be deferred for a wee while.
     
  8. Katharine

    Katharine · Well-Known Member

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    There is indeed some cardiovascular benefit but not in total mortality. Deaths from suicide, accidents and cancers balance out the reduced cardiovascular mortality. It is thought that very low cholesterol levels affect central nervous and immune system function.

    The cardiovascular benefits are usually put as relative risk statistics and when numbers needed to treat, side effects and direct costs are considered any benefit to the individual remains very small but possibly statistically relevant to middle aged men who have diabetes or cardiovascular problems.
     
  9. Trinkwasser

    Trinkwasser · Well-Known Member

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    Very statistically relevant if they have shares in drug companies <G>
     
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