Diabetes and statins

Amycav85 said:

I agree it's very important to be able to see your own results, it's so frustrating not being able to see them as I fret not knowing the numbers and the receptionists will never tell me either!

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If you are in the UK, ask for a printout of the full set of your most recent test results. As someone on here has already said, I'm pretty sure that access to your own test results is a right and they cannot refuse to give them to you. After all, it is your data about your health - not a state secret! The whole rational about Diabetes care in the NHS is that YOU are responsible for your care - your GP and the nurse are meant to be there to advise and help you but, at the end of the day, your day-to-day care is meant to be your responsibility. You can't do that if you don't have the data you need.

I've never had a problem getting my surgery to give me results but you don't need to speak to the GP or Nurse to get them either. The last time I had a set of Bloods done I simply went into the surgery (admittedly harder these days with Covid-19) and asked the receptionist to print them out for me.

Paul520785 said:

In my cynical opinion they are mainly a money maker for drug companies and should only be used where a medical professional makes a good case with reasons for their use.

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I might be wrong about this still being current policy, but is it not the case that GP's are incentivised (financially) under NICE guidelines to prescribe statins to what are defined as "at risk groups" - which is essentially those people who are considered to be at a 10% greater risk of having a cardiac incident. Those with Diabetes fall into that group.

I am sure you are doing the right thing, Amycav85. Statins can cause all sorts of highly undesirable side-effects. They affected my short-term memory quite severely, with the result that I couldn't do my job and was made redundant. The only side-effects nurses generally know about are the muscle/ joint pains that the manufacturer's generally admit to. I have always found it easier to have a rational conversation about statins with a doctor. Your practice nurse is likely to try to pressurise you to take statins whenever she looks at your records and realises you are not taking them. Attitudes to statins vary among the various staff members at my own surgery and even though my hospital records are now marked 'statin- intolerant' , the practice nurse still won't give up pestering me, so I have to avoid her in self-defence.

MDJ said:

I might be wrong about this still being current policy, but is it not the case that GP's are incentivised (financially) under NICE guidelines to prescribe statins to what are defined as "at risk groups" - which is essentially those people who are considered to be at a 10% greater risk of having a cardiac incident. Those with Diabetes fall into that group.

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Yep, diabetics along with at least half of the population. That's the problem, you end up with millions being prescribed them on a 'just in case' scenario with NO consideration given to an individual's actual health. Reached 50?, statin, got diabetes?, statin, well controlled health condition?, well, take a statin anyway. x

Amycav85 said:

Hi everyone,

So after speaking to the nurse today my hba1c has gone from 85 to 64 currently on 500mg metfomin twice a day. My cholesterol is 5.4 and she has told me I need to start statins because I'm diabetic and my cholesterol is high. Is anyone else on statins with that sort of level? I'm a bit scared to take them, she has also upped my metformin to 1g twice a day. Diagnosed with diabetes last November and this is the first time I have spoken to her. Feeling very anxious and down

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Amycav85 said:

Hi everyone,

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Hi Amy,

Firstly, well done on getting your blood sugar moving in the right direction! You are obviously doing something right.

Let me start by saying that your nurse, GP, or anyone else on your ‘diabetic team’, are not bad people, out to make your condition worse. They are only doing what they have been trained to do: assess and diagnose your condition in less than 10 minutes. The next step in the process is to look at the list of symptoms – again, all in the space of 10 minutes – before finally going to the list of symptom masking medications. As a diabetic, that usually means blood sugar, blood pressure and cholesterol management medications – and that’s just for starters.

I was diagnosed T2D just over three years ago. Honestly, I was relieved. I’d been losing weight – my trousers were literally falling off – for quite some time with no obvious explanation. My father died of cancer within a couple of weeks of being diagnosed.

My A1c, back then was 113 and my blood sugar – taken by my diabetic nurse with my new toy – was 13. I have friends and relatives who are diabetic, so, once the relief at being told it wasn’t cancer faded, I, too, felt very anxious.

Fortunately, I had an excellent practice nurse. As I had lost 20kg by the time I went to the doctor, she immediately offered me metformin, statins, and insulin. When I told her I would take the metformin, but not the insulin or statins, I did get a bit of push back, but she agreed to let me try for a month to see how it went. Just over three weeks later my A1c was down to 70 from 113 and my blood sugars – with the occasional morning high of 7 or 8 – was consistently normal. Naturally, there was no mention of statins or insulin after that. The following month, my A1c was down to 43 and my most recent reading was below 40. And I have kept a consistent weight of 76kg for almost 3 years by not following the nutritional advice given to me at my local heath centre.

Frankly, I was left speechless, by how ridiculous it was! Basically, eat plenty of bread, pasta, rice and potatoes with low fat spreads, skimmed milk and cut down on sugary treats. Really? All the while, keeping your blood sugar under control with a ‘balanced diet – whatever that is – and, of course, exercising more. Well, I’ve been a member of the local health club, where I was taking daily spin, attack, pump and insanity classes. I also enjoy hiking, cycling and yoga. Yet, there I was, being told I was diabetic – reading between the lines – because I’m lazy and greedy.

There is an absolute plethora of information and evidence out there proving that diabetes – type two at any rate – is not an irreversible condition that can only be managed with an ever increasing list potentially dangerous drugs. And I’m not just talking about YouTube, anti-esrablishment ranters from across the pond. Here in the UK, Dr Malcolm Kendrick, Dr David Unwin, Aseem Malhotra and many more, who will put you on the right path to a long, healthy life without the need for statins – a drug, incidentally, that, along with it’s other 300 or so ‘adverse reactions’, can cause diabetes and is attributed with actually raising blood sugar.

Long story short: don’t do the statins; do your homework! The only person who is truly interested in your health and well being, is you! My diabetes is in remission because I omitted the food that my body cannot process. If all you do is cut out bread, pasta, rice, potatoes, cereals and sugar, you’ll be more than half way there.

I wish you the very best of health! Just remember: you’re not alone!

There was a revolt against taking statins in France, and it was predicted that the death rate would increase with xxxx extra deaths expected - some time later, and rather red faced it was admitted that the death rate had actually decreased by about that number.
Whatever the arguments for taking statins, the total death rate is not something you can argue with.

Just a few weeks ago during a telephone conversation with the GP where my blood pressure was "perfect" and my cholesterol "within normal range", she said "So we dont need to give you statins...yet" !!!!
There is such a presumption that diabetes is down hill and on medications from here on.

MDJ said:

If you are in the UK, ask for a printout of the full set of your most recent test results. As someone on here has already said, I'm pretty sure that access to your own test results is a right and they cannot refuse to give them to you. After all, it is your data about your health - not a state secret! The whole rational about Diabetes care in the NHS is that YOU are responsible for your care - your GP and the nurse are meant to be there to advise and help you but, at the end of the day, your day-to-day care is meant to be your responsibility. You can't do that if you don't have the data you need.

I've never had a problem getting my surgery to give me results but you don't need to speak to the GP or Nurse to get them either. The last time I had a set of Bloods done I simply went into the surgery (admittedly harder these days with Covid-19) and asked the receptionist to print them out for me.

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You are absolutely on the money, when you state that the nurse or doctor charged with your diabetic care is only there to advise you. In the end, we have to make a choice of how best to manage our health.

As stated in my earlier post, I was fortunate enough to have a good nurse, willing to listen and deviate from, what I later discovered to be the NICE, tick-box spreadsheet. Postcode, age, gender – according to which, I’m already on borrowed time – and the like. When I was asked how I’d managed to reduce my A1c from 113 to 43 in a matter of months, I explained that I’d done my homework, and decided to cut out the starchy carbs and try intermittent fasting. Hey, it sounds fancy, but if it makes it easier, just think of it as having a late, or later breakfast. At this point, she admitted that she had been doing the same for months, and felt much better for it. Of course, she would not be allowed to suggest that I do the same – NICE and all – but could see how it would be beneficial.

Alas, she left the surgery about a year after my diagnosis. My case was then taken up by the GP, who happened to be the surgery manager. An excellent doctor, I’m sure, but I’ve never met him. Indeed, almost a year passed, before I contacted the surgery to ask if I should come in for a blood test. I made an appointment and had the blood test. Then...nothing!

After about eight weeks, I contacted the surgery again to find out what the results were and was finally told that everything was ‘okay’. Well, don’t get too technical on me! When I was being looked after by the diabetic nurse, I was able to ask about C reactive protein, triglycerides, liver function and even the irrelevant cholesterol levels. Based on this dumbed down analysis, I did, eventually get a call from the GP. Not regarding the results, but the fact that my medications did not match my profile. Firstly, as I had stopped taking the metformin within weeks of starting – hell on earth, I can tell you – imagine a life on the loo, and the rest of the time, non-stop farting like a donkey! I decided to give it a go without, and to my surprise: absolutely no difference.

So, back to the GP on the phone. As I had stopped metformin, I should also have stopped getting test strips on prescription too. The rational being that I had my blood sugar well under control. When I tried to explain that testing was key to maintaining good control, I was dismissed as the worried well. I was then given a lecture, about my condition and told I should be taking statins, ace inhibitors, oh, and proton pump inhibitors, if I needed them. When I asked if my cholesterol was unduly high, he told me it wasn’t, but that being a man in my 50s with T2D in my postcode meant I had a 28% chance of a cardiovascular event in the next ten years. When I asked if this was relative or absolute, I could tell that the ‘consultation’ was drawing to a conclusion. Nevertheless, I tried, in vain, to get any concrete figures regarding my test results. Given that my blood pressure is normally below 120 over 70 – whilst I’m not a doctor, I can read and write – I’d be lucky not to fall over every time I stood up if I were to take blood pressure lowering medication.

I was supposed to make an appointment shortly before this terrible pandemic took hold, but I didn’t get around to it as I was working away from home. Of course, I won’t now, as I’m sure the NHS will have its work cut out over the next couple of years.

Just so, you know, I’m not having a go at the good doctor. Although we have never met, I know from his treatment of my mother, that he is an excellent GP and that he genuinely cares about his patients. Indeed, his early intervention is what saved my mother’s life when she had cancer. That being said, many doctors are blissfully ignorant when it comes to all things dietary, and given the ever-increasing workload they have to contend with, I’m surprised they have enough energy left to drive home at night, let alone keep up with current research.

All the more reason for us to remain curious and share what we have learned.

MrsA2 said:

Just a few weeks ago during a telephone conversation with the GP where my blood pressure was "perfect" and my cholesterol "within normal range", she said "So we dont need to give you statins...yet" !!!!
There is such a presumption that diabetes is down hill and on medications from here on.

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I think that's because the treatment paradigm is all wrong. Basically, carry on eating sugary, high carbohydrate junk food, and take the blood sugar concealing medications. Become fatter, more depressed, and unable to participate in even moderate exercise - even something as fundamental as walking - because you're well on you way to obesity (exogenous insulin), muscle and joint damage, elevated blood sugars (statins), elevated blood pressure (obesity).

Why don't doctors put down the prescription pad for a day and ponder why people become fat and sick? Of course, with less than 10 minutes to make a diagnosis, it's much easier to join the dots from ill to pill. When did physicians stop being healers and become dealers?

Resurgam said:

There was a revolt against taking statins in France, and it was predicted that the death rate would increase with xxxx extra deaths expected - some time later, and rather red faced it was admitted that the death rate had actually decreased by about that number.
Whatever the arguments for taking statins, the total death rate is not something you can argue with.

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I'm sure you will have heard of the French paradox. I can't be sure now, but back in the 90s I spent an academic year in France and it was absolutely true that they 'put butter on butter'! They also tended not to eat ready meals, processed food, and I never saw walls of orange juice in supermarkets. They also smoked like chimneys back then, yet had relatively low rates of cardiovascular disease. And it was often cited that if you saw an obese person in the street, it was probably an American tourist.

Amycav85 said:

I'd eaten at 6pm the previous evening and had my bloods done at 9. Is that a level to be really concerned over then?

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I just did a bunch of research (I'm getting the same push from my doctor). The big risk for heart attacks come from sdLDL (small dense bits of cholesterol). Because these are hard to read directly, they use triglycerides as one of many stand-ins to estimate the likihood of elevated sdLDL. My triglycerides are .8. Three UK studies suggest that if they are below 1-1.2 there is very little risk of an elevated sdLDL. The study that addressed ranges beyond the little risk range suggests >2.3 is cause for concern

Other measures include the ratio of triglycerides to HDL and of total cholesterol to HDL.

I found a lovely little article this morning (arming for battle with my doc on Monday) on use of statins as a primary prevention tool: USPSTF statins as primary prevention. Sorry - it's from the US and uses US measurements - there are good converters online.

But, as others have said - you really need the entire set of cholesterol numbers to do a good evaluation. Some are quirky (triglycerides among them), so if your doc has prior tests those would be helpful as well.

Amycav85 said:

Are you not taking statins then? The gp said given my age its well worth trying to bring the numbers down myself so I'm more than happy to do that as it definitely gives me the extra push to be as healthy S possible without needing extra medication.

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Why do they think you need to 'bring the numbers down" in the first place?

Changing the ratios would help but if they think the absolute number is meaningful then they obviously know little about cholesterol.

Amycav85 said:

Are you not taking statins then? The gp said given my age its well worth trying to bring the numbers down myself so I'm more than happy to do that as it definitely gives me the extra push to be as healthy S possible without needing extra medication.

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Not at the moment. After the wonderful numbers in my signature line, I was diagnosed with cancer, work exploded, and I stopped eating the way I should. My numbers were bad in November, but my risk for a cardiovascular event based on those number is still about 6.2% over the next 10 years. Entities that aren't pushing statins for every diabetic suggest there is little benefit as a primarly prevention tool unless your risk of a cardiovascular event is above 10% and you have one or more risk factors. Even at my worst, it was only 7.7%.

But - someone put a bee in my doctor's bonnet about statins and he is pushing hard. We had agreed to meet again in 3 months and look at my cholesterol. He forgot to order cholesterol - still tried to push me into statins. I reminded him of our agreement. I had bloodwork on Mondy (and see him this coming Monday). At that time, I'll be back down 27 lbs, I expect my A1C to be around 6.3 (higher than I like, but my dawn phenomenon has returned), and my cholesterol levels to be on the healthy end of the spectrum.

Really glad you asked your initial question, by the way. I came to the site for information on statins (after being absent for quite a while), and your post was one of the top two - which led me to the motherlode of research (bulkbiker's thread). It made my research very easy - lots of good info & some terms I wasn't using in my research that allowed me to find articles that distinguished between primary prevention, and treatment post CVD.

Amycav85 said:

Thanks for your reply

my qrisk score is 3%. I'm definitely I came on here to ask questions that's for sure.

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At your age, mine would be 1% - but being 63 bumps it up quite a bit!

My understanding is the biggest heart attack risk is the build up of plaque in the arteries which statins claim to reduce.

The build up of plaque can be measured with a scan. However, scans come with a radiation risk and may not be effective below a certain age (length of time et c.). My wife has very high cholesterol and was being reccommeded by her GP to take a statin.She went to a cardiologist and had scan. Result > pulse of an athlete with zero plaque. So no medication required at age 70.
As a type 2, I then had a scan > very low plaque so no Statins.
All this proves is that we are all individuals and that one size fits all from the GP may not be right for you.
Suggest you push for a visit to a cardiologist and ask for a detailed risk assessment based on lipid evidence and a scan if risk warrents the potential benefit.