Medication

pau1200

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75
Type of diabetes
Type 2
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Tablets (oral)
Hi,

So I have started my journey using the low carb diet and with regular testing my blood sugars have dramatically changed, from being 13+ after eating to 8-9 and just recorded my lowest reading of 6 so diet is really important.

I have started my medication today and trying to follow the diabetic nurses instruction of one metformin with breakfast and evening meal and if I can handle it increase it to two. My aim is to come off the medication and control it with diet and a lifestyle change as I don’t want to be dependant on drugs if I don’t have too.
My doctor has also put me on atorvastatin to control my cholesterol but looking at my blood results my cholesterol is at 4 which is high but not that high. Most of the information online suggests that once you start on statins you never come off them. Is this really the case or with the lifestyle change and sticking to it can I be medication free?

Thanks
 

HSSS

Expert
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Well done on th reduction. It’s a good start to your journey.

It’s your choice to take the statin or not. The dr can only make recommendations. There is a whole,world of controversy about statins and cholesterol and their links to CVD. There are a number of threads on here you can search, particularly the one started by @bulkbiker which more recently has acted as a reservoir of information. It is not anywhere near as simple as the overall number. Ratios, particle size and quite frankly if there is much relevance at all are all questions to be asked. May I suggest you do some reading befor e making your choices. And whatever you decide you can always change your mind later and stop/start taking them at that point.

For what it’s worth my total on diagnosis was much higher than yours and I have chosen not to take statins. I’ve also refused to be retested til now as I was actively losing weight which can temporarily raise numbers (no matter how you do it not just lchf) as lipids are released from the body into the blood. I’ve now agreed to be retested at the next blood draw as weight has stabilised. I very much doubt that I’ll agree to statins after the results as I just don’t believe they mean what they claim they do, but I expect a noticeable improvement as most who make the changes I have done get better figures.
 
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HSSS

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Btw if the figure you quoted is total then it’s not above the recommended limits for the general,population and at the level for high risk people of which diabetics are classed as one type. So not even high just borderline at worst. Most sources place more weight on ratios though not total.

https://www.nhs.uk/conditions/high-cholesterol/
 

kitedoc

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Hi @paul1200, did your prescriber mention that statins, some more than others, can affect BSLs and thus HBA1C?

And was your prescriber able to show that taking statins actually make a statistically significant difference to the risk of heart disease and similar nasties.?

If you subscribe to zoeharcombe.com, a respected nutritionist, she will show that no studies have proved cholesterol causes heart and similar diseases, nor do statins change the outcome in any significant way - but as illustrated above statins do have side-effects - some very serious. Presumably your prescriber warned you about all those too??
 
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Resurgam

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9,850
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Do watch out for side effects - a few weeks of Metformin and Atorvastatin and I was wandering around in a daze - forgetful and unable to concentrate - I have had to learn all my songs again (I'm a folk singer) it took a long time for the muscular aches and pains to go away, the stiff joints did not last as lone - the itching subsided fairly quickly and the rampant diarrhea faded within days, but it was a very unpleasant experience.
Some people can tolerate the tablets no problem, but I was really rather ill - I was having suicidal thoughts - so I binned them. As I discovered that I had never needed them in the first place I was not best pleased.
 

pau1200

Well-Known Member
Messages
75
Type of diabetes
Type 2
Treatment type
Tablets (oral)
I didn’t even see the Dr just the diabetic nurse, the prescription had already been written for me. She explained that my cholesterol was high and it’s normal to take a statin with diabetes medication. I asked what it is supposed to do and was told that it reduces my risk of CVD and stroke and as my diabetes is not under control I am a higher risk.
We talked about my work and I explained I spend alot of time driving around the country and I don’t want to take any medication that could to become drowsy etc. She only mentioned nausea, excess gas and diarrhoea but said they clear quickly.
I will read the other treads for information, my head is spinning a little with everything that is going on, suffering from insomnia since changing to low carb which I guess is a side affect of changing my blood sugar.

Thanks again for your comments
 

Guzzler

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The insomnia is likely to be due to the stress of diagnosis plus the big changes you are making (well done on getting those readings lowered).

As to being put on a medication automatically by a nurse (in regard to the statin) please remember that health care professionals are there to guide us not to dictate. We should have an equal relationship but it is ultimately your decision on treatment.

Keep up the good work.
 

Flora123

Well-Known Member
Messages
1,078
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Hi,

So I have started my journey using the low carb diet and with regular testing my blood sugars have dramatically changed, from being 13+ after eating to 8-9 and just recorded my lowest reading of 6 so diet is really important.

I have started my medication today and trying to follow the diabetic nurses instruction of one metformin with breakfast and evening meal and if I can handle it increase it to two. My aim is to come off the medication and control it with diet and a lifestyle change as I don’t want to be dependant on drugs if I don’t have too.
My doctor has also put me on atorvastatin to control my cholesterol but looking at my blood results my cholesterol is at 4 which is high but not that high. Most of the information online suggests that once you start on statins you never come off them. Is this really the case or with the lifestyle change and sticking to it can I be medication free?

Thanks

Is that a total cholesterol of 4? That is not high. Apologies if I’ve missed something.
 

bulkbiker

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19,576
Type of diabetes
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My doctor has also put me on atorvastatin to control my cholesterol but looking at my blood results my cholesterol is at 4 which is high but not that high
4 is a completely "normal" level if you are talking total cholesterol which appears to be a pretty meaningless number anyway. I have a small thread on the matter that you may find interesting
https://www.diabetes.co.uk/forum/threads/cholesterol-and-statins.156985/

it may take a day or two to wade through but at the end you'll probably be better informed than your GP!
 
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Guzzler

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Is that a total cholesterol of 4? That is not high. Apologies if I’ve missed something.

No matter if Total Cholesterol is 4 or 14 it tells you absolutely nothing. The way lipids are measured (blummin' guidelines!) is incomplete. Best we can do here in the UK is calculate the HDL/Triglyceride ratio (which is not a bad market tbh) before decisions are made as to possible treatments if needed.

The latest presentation I've seen on guidelines (US but applicable to UK, too).

 

Rachox

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15,810
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You’ve taken a good choice only starting one new med at a time. Then if you get side effects you know which med it is that’s causing it. I take Metformin, which gave me an upset stomach for about a week, I tolerate it really well now. My latest total cholesterol test was 6.6 but my ratios (I’m sure there’s an explanation of ratios in @bulkbiker ’s info) are perfect so I’m not risking my non diabetic HbA1c and further side effects by taking statins, despite my health care team repeatedly offering them.
 

Tophat1900

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At no point am I advising you one way or the other, but personally, I find it rather odd and somewhat disturbing to be being given a prescription for a medication written by a doctor who I hadn't even actually seen. I just find the whole idea of whipping out a prescription pad without consultation on a new medication where no discussion has taken place to be poor practice imo. The right to question and ask questions has been completely shutdown.
 

Bluetit1802

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25,216
Type of diabetes
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Diet only
At no point am I advising you one way or the other, but personally, I find it rather odd and somewhat disturbing to be being given a prescription for a medication written by a doctor who I hadn't even actually seen. I just find the whole idea of whipping out a prescription pad without consultation on a new medication where no discussion has taken place to be poor practice imo. The right to question and ask questions has been completely shutdown.

Here in the UK we have nurses that are "prescribing nurses". They are able to prescribe a selection of medications. My own nurse is one of these. The GP will see at a later time that these meds have been prescribed and if he wishes he can stop them. It is only certain common meds that they can prescribe.

@pau1200 If that level of 4 was your total cholesterol, it is not high. The standard range for the general population is 3 to 5. For diabetics it is 3 to 4. However, this is a total of all the bits and bobs, including the good cholesterol, so you need to know the full breakdown. (HDL/LDL/Triglycerides).

It is possible that the 4 isn't your total cholesterol, it could well be your LDL or triglycerides. You need to find out, and you can find out by ringing the surgery receptionist and asking for a print out of your test results.

If the 4 is your total, then it could be you were prescribed a statin because "we give statins to all diabetics" (I am quoting from my own GP when she tried to force them on me when my cholesterol levels were within the normal range.)
 

Tophat1900

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Here in the UK we have nurses that are "prescribing nurses". They are able to prescribe a selection of medications. My own nurse is one of these. The GP will see at a later time that these meds have been prescribed and if he wishes he can stop them. It is only certain common meds that they can prescribe.

ok that makes more sense, thank you
 
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Resurgam

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What an optimist that nurse is to believe that side effects clear quickly.
If you are unlucky enough to react badly then it is impossible to leave the house after swallowing a pill, and explosive incontinence is no joke.
I can't imagine how anyone working as a driver would cope - though not everyone is affected, but if you are it is utterly miserable.
 

pau1200

Well-Known Member
Messages
75
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Here in the UK we have nurses that are "prescribing nurses". They are able to prescribe a selection of medications. My own nurse is one of these. The GP will see at a later time that these meds have been prescribed and if he wishes he can stop them. It is only certain common meds that they can prescribe.

@pau1200 If that level of 4 was your total cholesterol, it is not high. The standard range for the general population is 3 to 5. For diabetics it is 3 to 4. However, this is a total of all the bits and bobs, including the good cholesterol, so you need to know the full breakdown. (HDL/LDL/Triglycerides).

It is possible that the 4 isn't your total cholesterol, it could well be your LDL or triglycerides. You need to find out, and you can find out by ringing the surgery receptionist and asking for a print out of your test results.

If the 4 is your total, then it could be you were prescribed a statin because "we give statins to all diabetics" (I am quoting from my own GP when she tried to force them on me when my cholesterol levels were within the normal range.)

I have spoken to my doctors and got the full print out of latest results,

Calculated LDL cholesterol 3.8mmol/L
Serum cholesterol 5.3mmol/L
Serum triglycerides 1.2mmol/L
Serum HDL cholesterol 1mmol/L
Se non HDL cholesterol 4.3mmol/L

There are obviously other results but these appear to be the ones related to cholesterol, unsure what to make of them to be honest.
 

bulkbiker

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I have spoken to my doctors and got the full print out of latest results,

Calculated LDL cholesterol 3.8mmol/L
Serum cholesterol 5.3mmol/L
Serum triglycerides 1.2mmol/L
Serum HDL cholesterol 1mmol/L
Se non HDL cholesterol 4.3mmol/L

There are obviously other results but these appear to be the ones related to cholesterol, unsure what to make of them to be honest.
Was the blood taken after a fasting period or had you eaten/drunk something other than water in the 12 hours before the blood draw?
 

Bluetit1802

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Your total cholesterol is 5.3
Your HDL (good stuff) is 1
Your trigs (bad stuff) is 1.2
Your LDL (can be good, can be not so good) is only calculated, not measured, and is 3.8.

What it doesn't show is your trigs/HDL ratio, which ideally should be under 0.87. Yours is 1.2. This is the important ratio.

All you need to do is raise your HDL and the ratio will improve. It is a bit low at the moment. Statins do not do anything for the HDL. All they do is lower the LDL. However, carbs deplete the HDL, so reducing carbs will bring them back up to somewhere much better.

If you did not fast for this test, the triglycerides will be raised. It is necessary to fast (water only) for 12 hours before the test.
 

Flora123

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1,078
Type of diabetes
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No matter if Total Cholesterol is 4 or 14 it tells you absolutely nothing. The way lipids are measured (blummin' guidelines!) is incomplete. Best we can do here in the UK is calculate the HDL/Triglyceride ratio (which is not a bad market tbh) before decisions are made as to possible treatments if needed.

The latest presentation I've seen on guidelines (US but applicable to UK, too).


I know. Just quoting the OP :)
 
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