Diabetes and statins


#1

I am 75, on injectable Novolog and Teresiba, have a Dexcom, BGs within range, cholesterol is 140, no family hx of heart disease or stroke and I walk two miles a day. My ONLY risk factors are diabetes and age.

My question is: do all of you take a statin as part of your treatment regimen? My endocrinologist keeps pushing me to take at least a low dose. Feedback?


#2

After diabetes and its treatments, I’ve likely done more reading on statins and cholesterol than any other health topic. It’s hard for the average patient to make a judgment about statins due to all the conflicting information about it.

I took statins for several years and stopped about seven years ago. I went through another round of research when I received a coronary artery disease diagnosis recently. I have literally spent hundreds of hours reading studies, watching video discussions, and reading books about cholesterol and statins. I choose to use lifestyle modifications to treat my heart disease. I would choose statins if they worked but they do not, at least not to the extent portrayed by big pharma.

Here are my personal conclusions. Cholesterol does not cause heart disease. A large percentage of people who suffer a cardiac event have normal cholesterol while many people with very high cholesterol do not have cardiac events.

Cholesterol is essential for life. It is produced and used by every cell in the body and forms the building blocks of cell membranes. Studies have shown that cholesterol and longevity are directly related. Mortality in the geriatric population is highest among people with the lowest cholesterol and those with the highest cholesterol live the longest.

Statins are notoriously known for their side effects. Did you know that major statin studies screened out people who reported side effects during an initial “wash-out” period? Only the side-effect free demographic went on to complete the entire study. It’s no wonder that the incidence of statin side effects are under-reported by the pharmaceutical companies. Statin side effects include debilitating muscle dysfunction, type 2 diabetes, and dementia.

Your numbers are otherwise good. Why tempt fate?


#3

I haven’t done the research, I probably would not understand it if I had.
But. i do know when my doctor insisted I take a statin (T2 diet and exercise) I took a dosage from one of a family of statins, Some one from some where decided that my dosage was now considered too high. They changed me to another type of statin. In one week I went from running up hills (73 here) to it being too painful to walk up the same hill. By that time it was ok to take the higher does of the first statin. I still have the fear of being in pain just to walk. Let alone run.

To keep my doctor happy I do purchase statin #1 I take it when I feel like it, and throw away the rest.

When they say possible leg and joint pain, believe them.


#4

Terry, thank you so much for your thoughtful response. You really have researched this! I also have read a lot about this and could not justify it in my mind. It is always helpful to hear it from someone else…


#5

I am t1 and stations have been part of my many meds since my first heart attack. Haven’t noticed side effects but cholesterol #'s are great. Also suffer dvt so it’s doublely important to keep #'s down.


#6

if i was 140 I wouldn’t take a statin! I had to stop using one popular statin, pravastin, after about 4-5 years because it was messing up my liver numbers, specifically the AST and ALT values which began rising precipitously. To be sure it was that med, I got off of it for 3 weeks and got more bloodwork done. The numbers were back down to normal. Then I resumed the med for another 3 weeks, followed by yet another blood test. The AST and ALT elevated again, to similar high levels. Stopped it again, one more blood test which was normal. I told me endo I’m done with statins and he suggested I use Simvastatin. I’ve been on it for years now, with perfect liver numbers. The moral of the story is don’t take meds you don’t need.


#7

As with everything related to diabetes, each case is different. I have been on a statin for many years as a preventative measure. I have major heart disease on both sides of my family and with the length of my diabetes, we decided it would be best to be proactive. I am one of those lucky ones who don’t notice side effects as much as some do. My numbers are great and the prescriptions is free, so why not. It’s not hurting me and it might be helping. But as with all things diabetes, it is my treatment plan, not the treatment plan that would work for everyone.


#8

I’ve taken pravastatin for a number of years to bring my cholesterol numbers back inline. I have no side effects. I also have heart disease in my family. I have no plans on stopping my treatment.


#9

Now if I could only get that message to my endocrinologist!


#10

If there are no bad side effect for you, that makes total sense. I wasn’t implying that pravastin was bad for everyone–I was just pointing out that unnecessary meds may be worse than taking nothing. And that if side effects are bothersome (like muscle weakness), stop a med, or switch to another type.


#11

Dave, I totally agree.


#12

Well, my situation is different from everyone else in this thread, so maybe I shouldn’t post, but I thought I would.

I’m in my 30s and my endocrinologist has been talking about taking statins for years because I’ve had long-term Type 1 diabetes and my cholesterol was high according to Canadian diabetes guidelines (but not if I didn’t have diabetes). I refused for years based on what I’d read online. However, I was recently referred to a cardiologist for ongoing arrhythmia problems I’ve been having, and she prescribed a statin, so I decided to take it. I’ve taken other medications before that have produced side effects. I tell my doctor about the side effects and have always immediately been taken off the medication. I figured the statin would be the same.

I’ve had no issues with side effects and my cholesterol is now within target for the first time in ten years. My endocrinologist did cite studies concluding that statins were beneficial in people who had had Type 1 diabetes since childhood, though I don’t have any specific references, since this was just in discussion at an appointment. But the fact that I’m having other signs that my heart may be stressed at such a young age also played into my decision.

The bottom line for me is that I don’t know what’s right. Whether I take a statin or don’t take a statin, it’s a guess and a gamble. I do know that I want to live for another 50 or more years and have already had Type 1 diabetes for several decades. I know that many of the adults I’ve known who had Type 1 diabetes since childhood died in their 50s of heart disease. I know that scientists may not know all the answers, but I believe my doctors have my best health at heart. I also know the healthcare system here is not as corrupt as it is in the US in terms of pharmaceutical and insurance companies controlling what doctors prescribe.

So I decided that if a statin may help 30 years down the road, I will take it. I have a hard time believing that it will cause harm 30 years down the road. And if I encounter side effects, I’ll mention them to my doctor so the medication can be stopped.


#13

Jen, I was born and raised in Denmark and totally understand your thoughts about American pharmaceutical Cos influence on our doctors. If I were in Denmark, I would be approaching this differently and would probably give it a try. Also, I was not dx diabetic until 1998. So that makes a difference. I’m glad you responded because I think its important to keep in mind that we are not all alike and there is no one correct treatment for all diabetics. I brought this up because it has been presented to me by various doctors-non of them diabetic- as being the “correct” way to treat diabetes and I think we need to NOT let doctors putt all of us in the same box. At 75 I am very healthy and plan to stay that way for a long time.

I’m glad you are taking care of yourself. We all need to advocate for what is best for each of us, individually.

Thanks to everyone for the feedback.

“You must give up the life you planned in order to have the life that is waiting for you.” Joseph Campbell


#14

I have read much of the same info that Terry has read, but I feel stuck. Really stuck. I started on Bernstein’s woe about 12 or 13 yrs ago. Way before most diabetics did. After watching my LDL climb to supposedly dangerous levels, I was rushed to emergency and the next day I received two stents. I had had diabetes for 50 yrs. one of the cardiologists couldn’t believe that I was a diabetic because I had no other complications to speak of. He told me that I had probably
reached my peak and was on my way down. I then tried every statin In the book and Zetia. All caused bad side effects. I decided that it might be time to stop low carbing (30mgs a day). I had also gained a bit of weight.

So, about year and 1/2 ago I started following the two guys at Mastering Diabetes. They are both very bright type 1 diabetics.

I eat a vegan diet and try to keep my fat down to 10-15%. I almost immediately lost about 10 lbs. I am 5’1” and weigh 107 lbs. Not bad for an almost 70 yr old woman.

BUT, even though I ride my exercise bike 10 miles a day, my LDL is still 130. Much higher than my new cardiologist wants it. He wanted me to try one of the new injectable cholesterol
drugs. I asked if they were safe, and he said well yes, they were approved by the FDA. I almost laughed. I came home did some research and decided to not chance the side effects.

The other suggestion the cardiologist had is to take Crestor 40mgs once a week to see if that would lower my numbers. Taking it daily years ago raised my liver enzymes.

I recently had a nuclear stress test which I passed with flying colors. The cardiologist is ignoring the fact that when I had my cholesterol analysis done, i showed very few of the small density LDL particles. He no longer believes in those tests, although my naturopath thinks it is a great test.

I feel great, so want to just ignore my LDL, but I also don’t want to become a statistic.


#15

I won’t take one. If I needed it I’d probably explore other options first, as I react badly to a lot of medications. I don’t have an issue, my cholesterol is usually around 160-180 but I’m a vegan so that is only because it’s what my liver decides to make. My HDL is way high which is really good and that is probably because I eat nuts and avocados all the time, all the good things that help raise those HDL levels.

My recent (very missed) endo did a complete in depth break down of fats in my blood, it listed all sorts of things I had never heard of and everything was great. Heart disease does run in my family. Her comment was I won’t be having heart problems for a while. She had never tried to put me on statins. This extra panel was done right before I moved. My pcp Doctor also had never tried to put me on statins.

New Doctor and first thing she says is you need to take statins. That in depth wonderful blood panel was done in Sept, this is November. I brought her a copy. She didn’t care what my numbers were, because I’m diabetic I should be on a statin. She is also a very recent graduate so this is what they are teaching them. I told her if I had a cholesterol problem I would take plant sterols and she said there is no research on that, only on statins. That’s not true, maybe not medical research, but lots of studies.

Anyway we went round and round on it, she asked why and I asked why should I? , lol…it ended up with me saying I’m not taking them and if you are that unhappy I can switch doctors if you’d rather I do that. She finally backed off. Of course second visit, same thing but not as bad. She told me up front she will probably bring it up each time I see her!

She’s nice, but seems at odds with what I want so I might end up switching anyway. She loves medications, I do not. But she is a go getter, very young, not warped yet and had me in to a spine doctor and a visiting endo immediately. So that’s a plus! We’ll see how it works out!

Avocados! A fairly recent study came out they start cleaning out your arteries within 2 weeks and my old endo used to push an avocado a day for a diabetic! I love avocados!!!
Sigh, I miss my type 1 endo!!! Did I say that already?? Lol!

But I truly believe we are all different, you can try to prescribe me a pill and you literally have a 50/50 shot that I will have a bad reaction to it. So I am probably more vehement than most that I don’t want to take it. We all have to decide for ourselves what we want.


#16

I was very resistant to taking a statin until I found a cardiologist who feels the smallest dosage possible should be used if it’s effective. My LDL was consistently around 170 until I started taking 10 mg of rosuvastatin 2 days a week. On what is considered a very small dose, my LDL is now in the 80s and my HDL continues to be at a very high, healthy level. I don’t believe I’ve experienced any of the known side effects, but I do take a CoQ10 supplement every day. Given my hereditary risk of heart disease, I thought trying a tiny dose of a statin was the best compromise for me and it seems to be working.


#17

This is the dark side of medical standards of care. If you have diabetes, you need to take a statin. As a group, medical practitioners have agreed about their perception that statins are effective. If a doctor complies with the standards of care, they buffer themselves against legal exposure.

It’s too bad. I empathize with the doctors’ thinking but I don’t agree with them. Standards evolve. Statins will not remain but it’ll likely take a generation to fade.


#18

I’m watching one of The Teaching Conpany’s “Great Courses” called Behavioral Economics—- one of the half hour lectures is specifically on medical decision making. I found it very relevant to these types of discussions. It contains no medical advice of any sort whatsoever, just an exploration of the behaviors of medical decision making. I found it and many of their other lectures very good.

It’s available online as a single lecture for a dollar or two if anyone wants to search around… not sure where but I know I’ve seen it…


#19

Shadow2, this is the same drug my doctor wants me to try starting today. Last time I took Crestor my liver enzymes shot up. So, he wants me to take 40mgs once a week. My LDL is about 130, but I have 2 heart stents. I like what your doctor has suggested that you do much better than what mine has decided to do. 40mgs seems like too much considering that I react badly to statins. He also has not ordered any follow up testing to make sure my enzymes don’t rise.

Maybe I need to shop for another cardiologist once again.


#20

" If you have diabetes, you need to take a statin."

That’s OK. They can’t make you take your statin, presuming you fill the rx’s for it. :slight_smile: