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Twisted statistics (statins)

seadragon

seadragon

Well-Known Member
Messages
316
Type of diabetes
Prediabetes
Treatment type
Diet only
I was first told I had pre-diabetes a year ago but didn't at that time take it too seriously - was given a few diet notes about eating plenty of high fibre low GI carbs and referred to an education meeting at a local hospital. Life got in the way and i never made it to the meeting.

This year I went back for a second GTT and was told to come in and see the GP. Panic ensued as I presumed I must have passed in to full T2 diabetes. Not actually the case. Finally saw the GP (who is also the diabetic clinic practitioner). She said i was pre-diabetic with readings of fasting BS of 6.6 (! forget the 2 hour reading now) and she immediately offered me metformin and statins. I queried the statins in particular having heard not such great things about them and she said NICE guidelines are to offer them to anyone with a 10% risk of heart disease in next 10 years. Seeing I wasn't keen she advised me to go away and have think about it and return.

I looked up everything I could and read this site and others suggesting a low carb, higher (natural) fat diet. So junked the sweets and reduced my carbs and upped intake of fats and veggies and fruits etc as well as reducing the amount of wheat in my diet and instituted twice daily 30 minute walks. In two weeks I've lost at least 2KG and feel way better than I have in ages. Just before returning to the doctor I tested my fasting blood sugar with a borrowed monitor and got a reading of 6.1 (not perfect but heading in the right direction definitely).

Went to doctor with my reasons for not wanting to take metformin in that I'd like to see what diet and exercise can do to reduce my BS levels before using drugs which would mask any effects. I told her I would buy a meter and she was very dismissive of that idea. I told her my level had been 6.1 and she was dismissive of that too saying, "Oh well they're not as accurate as the venous readings."

On to the statins: So I quoted stuff i'd read online from telegraph articles (overwhelmingly against prescribing statins for everyone) to the NICE guidelines and said I didn't think it was worth it for the side effects given that it only cut the risk at best from 10 % to 6%. Oh she said 'but that's cutting your risk by nearly half!" Well I gave up at that point. I didn't bother to explain that cutting a risk from 10% to 6% is actually reducing your risk by just 4% or to put it another way it helps only 4 people out of a hundred people who take it. Or my risk of NOT having a heart attack or stroke is increased from 90% to 94% still just a 4% difference. So do doctors lack simple maths skills?

She didn't seem happy at my refusal to take the meds (I hate to think it could be because doctors get paid to prescribe these meds and the practice gets more money for more diabetic patients) but said it was my choice and I'd obviously made up my mind.

I did ask for my cholesterol levels as statins reduce cholesterol (she said - "it's not just that, they have a proven protective effect against heart disease" - well i'd like to know more about that if it's not just the effect on cholesterol which is all I could find evidence for)

So just wondering, has everyone who has been told they are pre-diabetic been offered statins and how many of you have decided to take them? And what else do they do beside reduce cholesterol levels since mine were 5.5 total, with HDL of 2.12 and LDL 3.0 with TG 0.8 which didn't seem too bad to me?
 
I'm no expert but have read a lot about statins as you have. My own risk is 14% and my dr recently told me I should take a statin as NICE recommend them with a risk above 10% and she knew I wouldn't be happy with that. She was right, I wasn't! I asked her whether given my hypertension and age - 72 - and otherwise good health she would take a statin and she said 'No'. She did say I could have another cholesterol test but if I wouldn't take a statin then there was no point! My cholesterol was 5.5 and the ratio was 2.7. I think this is possibly border line high but a year ago it was 6.4 so has come down somewhat.

As a prediabetic myself I would have told your dr where she could put her metformin and statins. I do feel if they want to get the population onto the things then they should be open about the side effects and stop denying that there are any. My own feeling is that they bury the evidence as big pharma would be adversely affected if they didn't.

And it is true that the practice gets paid for every patient they put on the diabetic register, or so I believe.
 
Before or in conjuction with offering statins the GPs (if they can be bothered to follow NICE guidelines) should be talking about exercise... There are guidelines for them. They do not follow them.

I myself am seeing my GPs and Practice Manager next week with our local gym. As I am concerned and the gym that they are not doing teferals or even talking about exercise to patients. Our gym offers fully trained REPS Instructors for illnesses such as depression, hypertension, diabetes etc but GPs just can't be bothered to do a simple referal form.

I have also had strong words with one of our CCG Executives (a GP in his day job) about this to try and get changes made.

The other argument against statins is that they can also contribute to diabetes....

GPs get paid for getting people within target levels with cholesterol and diabetes so unfortunately they will take the easy option. This is not solely their fault as many patients would rather swallow a pill than even consider changing their lifestyles...
 
It did seem to me she was just following a formula - 'Pre diabetes so here you go metformin and statins'. My actual cholesterol levels I was told were unimportant as 'statins have other protective effects' (but but she didn't specify these), she did not check my blood pressure or ask anything about my lifestyle or current diet. She said 'losing weight can help but you haven't got a lot to lose' and that was it. Well I've lost 3KG so far on the LCHF diet but didn't bother to try explaining that. i wanted to ask about the dangers of taking cholesterol levels too low since mine weren't that bad and too little is as bad as too much but felt it was probably pointless. She wanted to medicate me and I didn't want medication so she wasn't going to discuss further.

i also asked about statins effects on coQ10 and why it wasn't mentioned to people taking statins and she told me there 'wasn't enough proper evidence that co Q10 supplements help to prescribe them - or even to mention them it seems. I think in Germany they are prescribed along with statins (and in America statins have a warning about them increasing the likelihood or type 2 diabetes!

I felt that if I took the medicines she offered i'd be on a downward spiral of drugs.

Anyway I have agreed to go back in 6 months and in the meantime if anyone can recommend a BG meter then i'll order one and get testing!
 
Hi,

I am almost certain that Metformin is not licenced in the UK for GP's to prescribe to pre-diabetics. I know I have read this somewhere, and not just on a forum. Certainly in my Practice it is only prescribed to newly diagnosed with an HbA1c of above 53. 53 and under it is diet and exercise for 3 months then a review.

Your lipid profile looks absolutely fine to me, especially the Trigs, which are the nasty little critters. It is the ratios that more enlightened doctors are now looking at. The total/HDL ratio should be under 4. The trigs/HDL ratio should be under 1.3, and the non-HDL should be under 3.4.
 
seadragon said:
Anyway I have agreed to go back in 6 months
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@seadragon If you are anything like us, you wouldn't even be able to remember to go back next week, never mind in six months time!

Have you read "The Great Cholesterol Con" by Malcolm Kendrick? You can find out more about MK here, http://drmalcolmkendrick.org I think you might quite enjoy his book and blogs.
Sally
 
A friend of mine has a dr like yours seadragon. Luckily for her it was a locum but she did make my friend feel pressured to take a statin for borderline high cholesterol and really I don't think drs should be behaving like that. I'm not sure whether you are male or female but women do need more cholesterol than men I believer. I do think you should read Malcom Kendrick's 'Great Cholesterol Con' - and maybe your dr should too!

The trouble with all these tests and the pills that are prescribed is that they make patients out of well people which I know to my cost is frankly ridiculous
 
Thanks for the replies everyone. It reaffirms my belief that statins are not the right thing for me at this time. I'm still a bit torn about metformin since having read they can have heart protective effects by keeping the blood sugars low but feel if i take metformin straight away I'l not be able to find out what spikes my blood sugars and I think that is going to be valuable.
 
seadragon said:
Thanks for the replies everyone. It reaffirms my belief that statins are not the right thing for me at this time. I'm still a bit torn about metformin since having read they can have heart protective effects by keeping the blood sugars low but feel if i take metformin straight away I'l not be able to find out what spikes my blood sugars and I think that is going to be valuable.
Click to expand...

It is of course entirely your choice whether to take Metformin or not. (I don't). However, it won't stop you from discovering which foods spike your blood sugars. It doesn't work that way. It reduces insulin resistance, appetite, and the production of glucose by your liver, but all to a limited extent. It works much better for people with a lot of weight to lose. You will still spike after eating certain foods and will still be able to measure this with your meter.
 
Bluetit1802 said:
It is of course entirely your choice whether to take Metformin or not. (I don't). However, it won't stop you from discovering which foods spike your blood sugars. It doesn't work that way. It reduces insulin resistance, appetite, and the production of glucose by your liver, but all to a limited extent. It works much better for people with a lot of weight to lose. You will still spike after eating certain foods and will still be able to measure this with your meter.
Click to expand...

Hi, do you mean metformin works better for people with a lot of weight to lose. I don't have a huge appetite anyway and only want to lose a couple of Kgs as I'm on the high end of 'normal' wight for my height. Can I ask your reasons for not taking metformin yourself?
It seems that it might be protective by reducing the glucose produced by the liver which doesn't appear to be diet related so can't be changed by diet - or have I got that wrong?
 
Metformin is an appetite suppressant, so it helps people eat less and therefore hopefully lose weight. As I said above, it helps reduce the amount of glucose produced by the liver to a limited extent. It can have side effects, mostly tummy/toilet problems, but these disappear after a few weeks. It is known to be a safe drug. As I mentioned before, I am not entirely certain it is licensed for GP's to prescribe to non-diabetics (including pre-diabetics).

I have never been on any meds. I am diet only. My HbA1c at diagnosis was 53, so I was given 3 months to improve on diet only before being prescribed meds. I did improve and have continued to do so, therefore I remain med free, and hope to stay that way for a very long time. I am not a believer in shoving chemicals in my body unless I need them to stay alive! But that is just me.
 
After watching Trust me I m a Doctor yesterday I see no reason to trust doctors at all. The response to Almonds was particularly interesting. The overall view was that they had no effect (and that's the statistic that would be used) but looked at on a case by case basis they lowered cholesterol for some and increased it for others which just goes to prove we all react differently to things - a concept my doctor could not understand. She just parroted the 'reduced risk' line. But my cholesterol levels are lowish, triglycerides very low and I have just been reading new studies that show low trigs are as bad as high (just as low cholesterol overall can be bad for you). So those 4 out of 100 that the statins supposedly saved - were they diabetic? , did they have very high cholesterol levels? ( so many variables). I think the 'one size fits all' medical advice is very badly flawed so will be sticking to my diet and exercise plan for now. The good news is fasting bloods seem to be going down. Bad news is many foods cause a 1 hour post meal spike but now I have a meter I will be using it to see what I can safely eat. I'm very grateful to have found this forum and the helpful people on here.
 
Hmm - I just found the Q risk calculator and even putting in I'm diabetic (I'm insulin resistant or whatever but this is improving with better diet and exercise thanks to this forum) it calculates my 10 year risk as about 2.9%. Doctor claimed being pre-diabetic instantly gave me 10% risk and therefore I should take statins. This seems like madness to me, Why did she not do the Qrisk assessment and see that as a female with my lipids profile and no hypertension that even if I tick the box marked diabetes the risk is way less than she claimed.
 
I've just played about with the Q risk calculator, and the difference between non-diabetic and Type 2 in my case is 6.3%

.
 
I'm now going to google q risk calculator as I don't know what it is :) but you've made me curious
 
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