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What's the criteria for treating with Statins?

G

goji

Well-Known Member
Messages
251
Hi

Just wondered if anybody knows what criteria GPs use to stick diabetics on statins (apart from the nice bonus payments they get!! :lol: )

Do they go by Total,HDL, LDL, Triglycerides or some kind of ratio?

I'm a bit worried as I have a GP cholesterol test coming up.

I had this test done privately a few months ago (GP hasn't seen the results). Do you think my cholesterol meets the criteria for statins?

HDL 2.46
LDL 3.95
Triglycerides 0.58
Total Cholesterol 6.67

Thanks
Goji :)
 
Probably.

I was put on statins with total cholesterol of 6 - even after trying to get it down through diet.

I've had no side effects from them and within 3 months the reading had come down to 3.6.

It is known that higher cholesterol is associated with a higher incidence of cardiovascular disease, and that diabetics are at greater risk than non diabetics. This is why they have lower cholesterol targets for diabetics than for non diabetics.

There is no way that a doctor can guess which complications are likely to arise in which patient, so all they can do is to try to lower the risk factors in general.

It is your decision as to whether you wish to take their advice.
 
Thanks Romola

Glad to hear it's working for you.

So does that mean it is Total cholesterol they use as the treatment criteria?

Thanks Goji
 
Hi goji.

What a question. How long have you got ?

(Quote)
Cardiovascular disease (CVD) is the leading cause of death in England and Wales. CVD predominantly
affects people older than 50. Apart from age and sex, three modifiable risk factors – smoking, raised blood pressure and raised cholesterol – make a major contribution to CVD risk, particularly in
combination. The risk of a future CVD event can be calculated from these risk factors, and people at
higher risk can be identified. Blood cholesterol has a log–linear relationship to the risk of coronary
heart disease (CHD) and is a key modifiable risk factor. Blood cholesterol can be reduced by dietary
change, physical activity and drugs. This guideline addresses the identification of those at higher risk of CVD and the modification of lipids in these people and people with established CVD1. The care of people with conditions that may predispose them to higher risk of CVD, such as diabetes,
(end quote)

The criteria is long and very complicated. Here is just a single paragraph from the NICE guidelines regarding statin therapy. It is based on prevention and a risk assessment which uses a complicated formula involving the sex and ethnicity and a load of other factors as well. Too much to be posted here.
(Quote)
Statin therapy is recommended as part of the management strategy for the primary prevention of
CVD for adults who have a 20% or greater 10-year risk of developing CVD. This level of risk
should be estimated using an appropriate risk calculator, or by clinical assessment for people for
whom an appropriate risk calculator is not available or appropriate (for example, older people,
people with diabetes or people in high-risk ethnic groups).
● Treatment for the primary prevention of CVD should be initiated with simvastatin in the first instance.
(end quote)

There is MUCH more.... :(
 
Hi Goji,

Trigs are usually proportional to your BG levels. My trigs were "catastrophic" at 7.7. After 3 months I got my HBA1C down from 10.3 to 5.8 and my trigs dropped from 7.7 to 1 !!!
Hence if BG's are on the down side, no need for drugs for trigs.
I was told that statins not necessary as long as I keep overall cholesterol below 5.(currently 4.8!)
PS where did you go for private lipids testing, I enquired at Lloyds pharmacy and they said £15 for overall cholesterol only - No trigs/LDL/HDL.

Steve.
 
Thanks Cugila for that info - I had no idea it was so complicated. Here I was thinking my GP had some basic cut-off point. I'll have to sit and digest that info further! :)

Steve, that's really encouraging to hear how much improvement you got with your Trigs. I didn't know about the BG/Trig connection - it's definitely a good incentive to keep my BG lower.

I got my bloods done while abroad - it's a lot cheaper than England! However, I know of one place that I use to get thyroid tests done privately. They do a full cholesterol panel: (TC; HDL; LDL; Triglycerides) (Fasting) for £34.00. They send the kit to your home and you get your results sent directly to your home so no doctor involvement!

The only problem is you have to get someone to do the phlebotomy. Some people persuade their local surgery nurse to do it for free, others have nursey friends. The alternative is to get the blood drawn at a local private hospital - costs around £20. The company provides a list of local private hospitals that will agree to do the phlebotomy. Once the blood is drawn you post the test back to the lab.

I don't think I'm allowed to post links to commercial companies but you can google Lab 21 - the profile's listed under 'clinical lab' and then 'cardiology'.

All in all it's probably a lot more cost-effective to get the tests through the NHS especially if your doctor isn't too interfering.

Goji
 
Hi Goji,
I remember reading somewhere that below 4.0 mmol/L should be the target for Diabetics, it seems lipid panel levels don't come into it when prescribing statins just the total cholesterol.
The link shows that its mainly LDL that is affected by statins, there's little benefit for trigs and HDL.

http://www.medicine.ox.ac.uk/bandolier/ ... tdiab.html

Graham
 
my glucose readings are also out of control for 9 months now. nothing seems to help, diet changes up the yin yang, shooting more insulin [humalog and lantus], less meals, small meals, no meals at all.i test and shoot on waking, before and after meals, before bed. i wake and i am at anything from 135 to 415, 135 is rare. no patterns to any of it. i am continuing to adjust insulin upwards.
i also have other peculiar symptoms such as an enlarged fatty liver for 2 years, now at over 25cm, not one but two enlarged spleens, terrible bone pain in lower legs, cramping muscles all over my body including chest muscles if i should twist around from the hips to get something from behind me. i have severe gastroparesis [Rx cilroton with food], CHF and very rare bouts of unpredicatable angina [Rx Digoxin and Spironlactone]. 2 enlarged lymph nodes in left groin for 2 years. total thyroidectomy due to cancer 12 years ago [Rx levothyroxine] and as of 2008 thyroid tissue re-growth with a biopsy of follicular cells. i am dizzy and nauseous all day long, sometimes the dizzy feeling goes to full on vertigo twirlies as i call them and i have to sit/lay down. cant do much, short of breath, cant walk far, doing the dishes exhausts me and i end up on the couch asleep for 5 hours dead to the world to recover. my cholesterols are also bad.
i was diagnosed with lymphoblastic leukaemia in 2006 but i am supposedly in remission. i have been coughing since diagnosed with CHF in 2005, lungs fill with fluid each evening, cough getting worse, cough rx no help. losing swallowing reflex the past 4 months. i have dropped from 175lbs to 165 in ten days but don't really know why. my blood levels in all areas are not right. my doctors are more overwhelmed with my symptoms than I am. we continue to do blood tests, CT and MRI scans...a brain MRI just showed numerous UBOs and an 8mm something in the frontal area. i just had 66 skins cancers frozen off all over everywhere. at least if i could get the diabetes under control it would be one thing off my list...
i am a type 1.5 diabetic and cant find any ''1.5 place'' to post on.
 
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