Statins

[oldminer88]

Just looking for some feed back from people.Had heart attack 2 yrs ago started on 80mg Atovastatin minimum dose Ramapril and Bisoprolol plus aspirin. 2weeks later quadruple heart bypass.
Blood H1Ac before this 41 now upto 46 , doing low carb diet 16 fasting 4000 steps after every meal nothing makes any difference. Anybody have any ideas?

 

[HairySmurf]

Hi @oldminer88

Statins are known to raise HbA1c by a small amount, though different studies give slightly different figures for the magnitude of the effect. This study - Link - indicates that Atorvastatin 80mg would raise HbA1c by around 5%. That would bring a HbA1c of 41 up to around 43.

If you are concerned about the effect of the statin you may be able to talk to your doctor about a change. There is another cholesterol medication called Ezetimibe which does not have quite the same effect on BG. Studies I've found give mixed messages on the exact effect on HbA1c, though this one for example - Link - shows no effect on BG with Ezetimibe. On it's own Ezetimibe is less effective for most people than a statin for controlling cholesterol, though when used in combination with a low-dose statin it may be equivalent to a high statin dose - Link

Interestingly, Ezetimibe used in combination with a statin may lead to superior cardiovascular health outcomes for diabetics than use of a statin alone - Link

Despite the apparent benefits I am having great difficulty in convincing my own doctor to prescribe Ezetimibe as the guidelines seem to say 'statin first'. If you would like to make a change you might have an uphill battle to convince your doctor the change is worthwhile.

Again though, the statin probably only accounts for a 5% rise in your HbA1c. The rest might possibly be due to a rise in insulin resistance levels. If you have weight to lose then addressing that might well have a bigger effect than changes to your statin dose.

*Edited for typos

 

[oldminer88]

BMI 23 only 10st no room to loose more weight

 

[Jasmin2000]

Hi @oldminer88

Statins are known to raise HbA1c by a small amount, though different studies give slightly different figures for the magnitude of the effect. This study - Link - indicates that Atorvastatin 80mg would raise HbA1c by around 5%. That would bring a HbA1c of 41 up to around 43.

If you are concerned about the effect of the statin you may be able to talk to your doctor about a change. There is another cholesterol medication called Ezetimibe which does not have quite the same effect on BG. Studies I've found give mixed messages on the exact effect on HbA1c, though this one for example - Link - shows no effect on BG with Ezetimibe. On it's own Ezetimibe is less effective for most people than a statin for controlling cholesterol, though when used in combination with a low-dose statin it may be equivalent to a high statin dose - Link

Statins raised my average BG by 20% and specifically spiked my normal spikes (carbs and hormonals) further. But cholesterol reduction is essential so I've increased insulin levels. Fingers crossed.

Interestingly, Ezetimibe used in combination with a statin may lead to superior cardiovascular health outcomes for diabetics than use of a statin alone - Link

This is interesting as Ezetimibe can't substitute statins as it doesn't block your liver cholesterol synthesis, but a combination with statins giving extra cardiovascular benefits would be a plus. Unfortunately it gave me aches and pains, headaches and wind!

 

[HairySmurf]

Statins raised my average BG by 20% and specifically spiked my normal spikes (carbs and hormonals) further. But cholesterol reduction is essential so I've increased insulin levels. Fingers crossed.

Yes, sorry I should have been clearer. That paper also indicates that 80mg Atorvastatin raises fasting plasma insulin levels by 45%. If you're injecting all your insulin the effect would (presumably) be huge, though if a body is producing insulin constantly this would I assume largely compensate for the effect of the statin. Largely, but not completely.

 

[Jasmin2000]

Yes, sorry I should have been clearer. That paper also indicates that 80mg Atorvastatin raises fasting plasma insulin levels by 45%. If you're injecting all your insulin the effect would (presumably) be huge, though if a body is producing insulin constantly this would I assume largely compensate for the effect of the statin. Largely, but not completely.

Makes sense, and my bad as I'm a bit T1 fixated and of course for T2 and non-diabetics the difference would be different.
Although there is the great statin scandal of 2013-17 where many non-diabetics became T2 due to BG/A1c increases. The cohort hit hardest were the over 60's where incidence of T2 increased nearly 40% over those without statins.

 

[Jordi77]

My BMI was high before I was in my late 20 now it's 23 and I'm classed as under weight and I'm 6 foot 3 and yet I'm only on 80 mgs Atovastatin at night and insulin 5 times a day and I eat like I want to and I cholesterol is less than it should be as I've been on statins for most of my diabetic years and it rose slightly a few years ago but now it's lower than the ground and I feel fine using them as normally my sugars go high due to what I eat not by the statins and the only thing I find is my body feels worse for wears but that's life now and you just have to get on with it and as a former smoker my chest is clear with nothing in it and as a vaper it is the same the only problem is I still need the nicotine in my vape which I add when needed and that goes to the same ratio of how many cigarettes I smoked and that was 30 a day to 2 18ml nicotine shots and that is the only thing that I can say that increases my sugars are the sweet juices as I have checked