I’m just wondering what you all think of being held to a different standard than a non-diabetic - is it too cautious, or of a benefit?
In general, I like to medicate myself as little as possible (T1 diabetes, ~60 u/day). The last 2 years I’ve been taking vytorin, my blood cholesterol panel is in the normal range for a non-diabetic, by my GP wants the triglycerides to be even lower and the HDL to be even higher. I stopped taking the Vytorin 30 days before my last blood panel and
triglycerides = 48 (normal range for the lab 30-150)
cholesterol = 162 (normal <200)
HDL = 57 (normal >40)
LDL = 94 (normal < 100)
So, benefit, overcautious because of the diabetes, or is anyone aware of any studies that show that improving these #s really makes a difference in a diabetic?
Opinions?
Sounds like you don’t need Vytorin. But I’m not your doctor, just a fellow diabetic.
I have wondered this same thing. Are there really studies to back of these cholesterol recs for diabetics, or is it based on theory? Not sure.
I won’t quote numbers for diabetes and CV disease. They are way too depressing. Your lab numbers are like everything else. There’s normal and then there are numbers that are “better” than normal. Right now, when it comes to CV disease, there is bit of a discussion going on about which numbers matter and which don’t. Like you said, your numbers look fine, but the numbers that my endo likes to point out is your Chol/HDL risk ratio and trig level. From my lab worksheet, the average, or “normal” if you will, CV disease risk is 20-25% if your risk ratio, for women, is 3.8-5.5. That risk is cut in half if you can get it down to 2.5-3.7.
YMMV
Yours right now is 162/57, or 2.8, so it’s good. However, simple math tells you there are two ways to lower your risk ratio even further, decrease your overall cholesterol, or increase your HDL.
It looks like your GP is basically following the same guidelines as mine by suggesting the current course of action.
4 years ago my primary care doctor suggested I take a cholesterol med even though my numbers were in the higher normal range. When I asked why he said that research suggested that as diabetics the earlier you treat the better off you are. At that time I was finishing my doctoral degree (in audiology completely unrelated), but we had really been discussing how you have to look at the study design to figure out how to apply it to what you do. What I found at that time is that there is a lot of research suggesting that holding Type 2 diabetics to a different cholesterol treatment level was beneficial, but the studies had not included Type 1 diabetics. We decided at that time that my cholesterol was fine and not to treat early, but we would keep an eye an it. I have not had any other doctor suggest a cholesterol med since then.
As always YDMV and I may have benefited from starting the medications early, I feel my doctor and I made the right choice for me.
I’m extremely lucky when it comes to my lipid panels. My numbers are such that I don’t really have to worry about taking medications. It is interesting that for every ad on TV I’ve seen for lipd medications, one of the disclaimers and cautions is that they have not been shown to affect CV disease risk either way.
I definitely try to have a lifestyle that mitigates CV risk though, and as a result, my lipid panels are pretty good. My HDL is just under 60 though, so I’ve decided that it would be a good idea to include an occasional glass of red wine with dinner. I actually read a study that showed that it doesn’t really matter what your alcohol of choice is when it comes to rasing HDL, the particular study used Vodka, but I figure there are other benefits to drinking red wine, so that’s my choice.
I know, it a HUUUUUGGEE sacrifice to make, drinking red wine with dinner, but I’m in this for the long haul and if thats what it takes… =)
Understand that statins like those included in Vytorin lower both your LDL and your HDL. In my view, the only cholesterol numbers that matter at all (and they matter a lot less than keeping your blood sugar under control) is HDL and tris. Your tris and HDL are actually fine. You may find stopping Vytorin (and that is good because Vytorin is risky) will raise your HDL some. You could also eat more good fats, exercise more and drink red wine. As I understand it, levels of HDL above 60 mg/dl are of diminishing returns. You are unlikely to lower your tris much at all. Everyone will have some modest level of circulating tris (while they are alive).