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<blockquote data-quote="phoenix" data-source="post: 387888" data-attributes="member: 12578"><p>I don't think that anyone wants to 'pop' pills. I also doubt very much that the NHS or other National Health care schemes wants to prescribe drugs without good reason.</p><p> The Swedish study was of women who were without any existing CVD , this isn't the case for many people with diabetes, particularly those of us who are older. I also note that though we know the cholesterol level at the start of the period, nowhere can I find any mention of how many of the subjects with high cholesterol levels took statins/treatment during the intervening period. This seems to be a very large potential confounder; I would have thought that people with very high levels would be likely to have been prescribed medication given the cholesterol programme described by the authors ( I may have missed it edit: they do actually mention it as a potential confounder, they had no knowledge of the medications taken by the participants but state that they don't think that it would have been a significant number during this period ie 1995 onwards ? )</p><p></p><p>The very recent Canadian diabetes guidelines have lowered the age at which they say that all diabetics should be on statins to 40. I'm not sure I agree with this, I think all risk factors need to be taken into account . It's interesting though to read the evidence .</p><p>Their primary evidence was from the reduction in cardio vascular events in two major studies of people with diabetes. These studies both included women. Both studies were from the UK . The MRC/BHF Heart Protection Study was the first to provide info from larger populations of women and people with diabetes. The second (CARDS) focused specifically on the role of a statin in patients age 40 to 75 with type 2 diabetes, without cardiovascular disease and with average or below average cholesterol levels. (half took atorvastatin, half took a placebo)</p><p>The first link is to the description of the reasons for their decision and summary of the evidence in the Canadian guidelines</p><p><a href="http://guidelines.diabetes.ca/Browse/Chapter22" target="_blank">http://guidelines.diabetes.ca/Browse/Chapter22</a></p><p>The second is to a more general link which also describes the CARDS evidence for the use of statins for women with diabetes.</p><p><a href="http://my.clevelandclinic.org/heart/disorders/cad/diabetes-women-cardiovascular-disease.aspx" target="_blank">http://my.clevelandclinic.org/heart/dis ... sease.aspx</a></p><p></p><p> As all these big trials have some input from the pharmaceutical industries and I know people may like to be aware of the funding sources of the trials.</p><p> CARDS was funded by Diabetes UK, the UK Department of Health, Pfizer UK and Pfizer Inc.</p><p>The Heart Protection Study 'funding of 21 million GBP (US $32 million) was provided by the UK's Medical Research Council (MRC), the British Heart Foundation (BHF), and the pharmaceutical companies Merck & Co. Inc. and Roche Vitamins Ltd. The study was, however, designed, conducted and analysed entirely independently of all funding sources by the Clinical Trial Service Unit (CTSU) of Oxford University quoted from <a href="http://www.ctsu.ox.ac.uk/~hps/pr.shtml" target="_blank">http://www.ctsu.ox.ac.uk/~hps/pr.shtml</a></p></blockquote><p></p>
[QUOTE="phoenix, post: 387888, member: 12578"] I don't think that anyone wants to 'pop' pills. I also doubt very much that the NHS or other National Health care schemes wants to prescribe drugs without good reason. The Swedish study was of women who were without any existing CVD , this isn't the case for many people with diabetes, particularly those of us who are older. I also note that though we know the cholesterol level at the start of the period, nowhere can I find any mention of how many of the subjects with high cholesterol levels took statins/treatment during the intervening period. This seems to be a very large potential confounder; I would have thought that people with very high levels would be likely to have been prescribed medication given the cholesterol programme described by the authors ( I may have missed it edit: they do actually mention it as a potential confounder, they had no knowledge of the medications taken by the participants but state that they don't think that it would have been a significant number during this period ie 1995 onwards ? ) The very recent Canadian diabetes guidelines have lowered the age at which they say that all diabetics should be on statins to 40. I'm not sure I agree with this, I think all risk factors need to be taken into account . It's interesting though to read the evidence . Their primary evidence was from the reduction in cardio vascular events in two major studies of people with diabetes. These studies both included women. Both studies were from the UK . The MRC/BHF Heart Protection Study was the first to provide info from larger populations of women and people with diabetes. The second (CARDS) focused specifically on the role of a statin in patients age 40 to 75 with type 2 diabetes, without cardiovascular disease and with average or below average cholesterol levels. (half took atorvastatin, half took a placebo) The first link is to the description of the reasons for their decision and summary of the evidence in the Canadian guidelines [url=http://guidelines.diabetes.ca/Browse/Chapter22]http://guidelines.diabetes.ca/Browse/Chapter22[/url] The second is to a more general link which also describes the CARDS evidence for the use of statins for women with diabetes. [url=http://my.clevelandclinic.org/heart/disorders/cad/diabetes-women-cardiovascular-disease.aspx]http://my.clevelandclinic.org/heart/dis ... sease.aspx[/url] As all these big trials have some input from the pharmaceutical industries and I know people may like to be aware of the funding sources of the trials. CARDS was funded by Diabetes UK, the UK Department of Health, Pfizer UK and Pfizer Inc. The Heart Protection Study 'funding of 21 million GBP (US $32 million) was provided by the UK's Medical Research Council (MRC), the British Heart Foundation (BHF), and the pharmaceutical companies Merck & Co. Inc. and Roche Vitamins Ltd. The study was, however, designed, conducted and analysed entirely independently of all funding sources by the Clinical Trial Service Unit (CTSU) of Oxford University quoted from [url=http://www.ctsu.ox.ac.uk/~hps/pr.shtml]http://www.ctsu.ox.ac.uk/~hps/pr.shtml[/url] [/QUOTE]
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