Type 1 Type 1 diabetic and high cholesterol

Yes - at every annual review I get told by GP's diabetes nurse that my cholestrol is a bit high and I should consider statins. My endocrinologist told me that my ratio of good cholestrol to bad cholestrol is good (do you know your test results?) and that I shouldn't be too worried so I have always refused the pills.
Statins can have a negative impact on glucose control so I prefer to take the risk but I was diagnosed T1 at 54 and I'm 61 now so a slightly different perspective for me - I've already had a good run if know what I mean.

According to all the historical data, the risk of cardiac problems is higher for someone with diabetes. Therefore, more attention is paid to our cholesterol and the recommendations are to take statins.

Personally, I have a number of concerns with this
- the historic data is very blunt - you have diabetes or you don't. Little attention is paid to how well your diabetes is managed.
- historically, we have not had the tools to manage our diabetes (fast acting insulin, insulin pumps, CGMs, ...) that we have today so it was harder to maintain (or even know that you are maintaining) good blood sugar levels
- research into statins has shown a benefit if you are overweight and unfit. To my knowledge, there has been no research into the benefits of statins for an active person of a healthy weight.

Based on this, I have chosen to focus on managing my diabetes with the tools I have available to me, not going overboard with "unhealthy" food (but not completely banning myself from the odd cake or portion of chips as long as I bolus for it), keep active, maintain my weight, continue to monitor my cholesterol and not take any tablets for it unless it rises significantly.

Kels* said:

Thank you for your response , I just feel am still slightly young to be taking any tablets, I eat a balanced diet and not classed as obese . I do enjoy a drink but don’t smoke maybe I will just try to keep my self healthy as can be and wait a few years before considering any tablets yet .

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Hello and yes I am nagged at every review because in the tick box list of co morbidities, heart disease is very high and the prevailing belief is that a high LDL cholesterol is a good predictor of risk and that reduing the LDL (as a stain undoubtedly does) will reduce the risk. The doctors have raised the bar for diabetics by having a lower number at which a statin is indicated than if you weren't diabetic.

Mine is 6-7.4 of which a decent part is LDL though I also have naturally high HDL and eat low carb (cheese, butter push my LDL up) and am pretty active so there's nothing to make me thing the ldl circulating around my blood is burrowing into my arterial walls and causing clots but without a calcium scan nobody knows. Your LDL measurement is only a proxy and possibly not a good one.

From what I've read High LDL is NOT a great predictor but HDL/trig ratio is.
So as a type 1 and in the absence of a more convincing reason to take an extra pill, I opt for keeping an eye on the HDL/trig ratio which is good in my case.
High glucose levels as you will have as type 1 will damage your arteries so the priority should always be keeping in a good range as well as not doing other things that would damage them such as smoking/drugs/sitting down too long.

Hi. We've all been offered statins as we have diabetes and/or elevated Total Cholesterol. If you have well-managed diabetes you are no different from a 'normal' person. Your Total Cholesterol doesn't mean much. You need to insist on a full lipids panel at you next blood test. This will show your various ratios e.g. LDL, HDL etc. Only have the statins if your ratios are bad. NICE is the problem with this. They insist on defining your total cholesterol as a measure which is bad science and they have set the diabetes level as 4 instead of 5 - a number picked from thin air.

I found a lot of the information on Youtube search low carb downunder then search videos for ldl. If you are doing low carb then make sure you fast for 12 to 14 hours before the blood sample (its one of the tips on one of Dave Feldman's videos ... sorry can't remember which).
Statins are required for some conditions but generally over prescribed ... and have side effects

Daibell said:

Hi. We've all been offered statins as we have diabetes and/or elevated Total Cholesterol. If you have well-managed diabetes you are no different from a 'normal' person. Your Total Cholesterol doesn't mean much. You need to insist on a full lipids panel at you next blood test. This will show your various ratios e.g. LDL, HDL etc. Only have the statins if your ratios are bad. NICE is the problem with this. They insist on defining your total cholesterol as a measure which is bad science and they have set the diabetes level as 4 instead of 5 - a number picked from thin air.

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So true but you will note from the Q Risk (bingo sheet) calculator actual LDL is not included but only indirectly inferred from the question about total CHO/HDL ratio.

My consultant told me that studies have shown that cholesterol levels in Type 1 diabetics did not affect their chances of cardiac problems.