My 2 cents, I think blood sugar that isn’t always within the normal range contributes to elevated cholesterol in diabetics.
Well, that book uses some faulty reasoning and oversimplification too. For a more nuanced view: Exploring “The Great Cholesterol Myth”
I agree, “everyone needs to take” is nonsense. In my opinion it’s unnecessary and a waste of money.
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Thanks for the link. An interesting read. I wish the review had commented on the observations in the book about the effects of statins on post-menopausal women, including the possibility that they increase depression. My primary goal is to educate myself for my specific situation and make sure that my choices, whatever they may be, are truly doing myself no harm.
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That’s a good attitude, ‘one size fits all’ doesn’t work in health care. Science is moving towards a more personalized approach to medicine. So I hope that docs will stop saying that all people with disease X should do Y. Y doesn’t work for all X patients.
When I was first dx’d I has A1C of 9.1 and fasting of 209 but my cholestrol was perfect, so I am not sure that having low BG will always results to low cholestrol… Now that i have been diabetic for 6 years and my BG is more controlled cholestrol is now increased.
Neither am I, because it won’t. I’m convinced that it was the low carb diet and attendant weight loss that did it. The diet also helped with BG control. The lipid improvement and BG improvement were both results, not causes.
Science may be, but the U.S. health care system is not–not yet. You are fortunate in that respect.
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If there are too many carbs in your diet, your liver will convert the excess into saturated fats and cholesterol in order to store the extra calories for later use. One more reason to control your blood glucose.
this study looked at the history of 60,000 Diabetics after av. 2.7
retinopathy HR=0.6 [decrease of risk]
neuropathy HR=0.66
gangrene of the foot HR=0.88
diabetic nephropathy HR=0.97
[neutral…HR=1.0 ]
diabetes HR=1•17 [increase of risk]
the way I look at it …if nothing else take statin for neuropathy, retinopathy and gangrene of the foot
Except that they were testing only whether statins increased the risk:
Use of statins before diagnosis of incident diabetes was not associated with an increased risk of microvascular disease. Whether statins are protective against some forms of microvascular disease—a possibility raised by these data—will need to be addressed in other studies similar to ours, in mendelian randomisation studies, and preferably in randomised controlled trials.
I assume you weren’t trying to misrepresent. Remove ‘only’ and it is accurate. What they found was it decreased risk and the diabetics on statins would have been considered at higher risk, than those that weren’t.
But what they concluded was that their results raised the “possibility” that statins were protective, but whether that was the case “will need to be addressed in other studies” similar to theirs. In other words, the researchers did not conclude statins protected against those risks.
EDIT to add that I was being very specific by using the word “only.” The researchers themselves stated:
The role of statins in the development of microvascular disease in patients with diabetes is unknown. We tested the hypothesis that statin use increases the risk of diabetic retinopathy, diabetic neuropathy, diabetic nephropathy, and gangrene of the foot in individuals with diabetes.
Bold emphasis mine.
OK, it wasn’t deliberate, it’s the terminology that is confusing ,
observation vs causation and the need for randomised controlled trials.
I thought the chart was simple enough and showed those diabetics who took statin and those that didn’t. and the rate of diseases they had.
the ones that didn’t take statins is the vertical line.
for the ones that took statins …left had side of the vertical line is less disease, right hand side more disease.
so they observed the 215,725 person-years data and it showed that stains improved out comes in those that took them, to prove this there would need to be a trial
…
Findings
During 215,725 person-years of follow-up, 2866 patients developed diabetic retinopathy, 1406 developed diabetic neuropathy, 1248 developed diabetic nephropathy, and 2392 developed gangrene of the foot.
Compared with non-statin users, statin users had a lower cumulative incidence of …
diabetic retinopathy
diabetic neuropathy
and gangrene of the foot
but not diabetic nephropathy
These results were similar after adjusting for the competing risk of death, after matching for a propensity score, after adjusting for visits to a family doctor, and by stratification on covariates.
Interpretation
Use of statins before diagnosis of incident diabetes was not associated with an increased risk of microvascular disease. Whether statins are protective against some forms of microvascular disease a possibility raised by these data—will need to be addressed in other studies similar to ours, in mendelian randomisation studies, and preferably in randomised controlled trials.
No, it did not show that “statins improved outcomes.” It suggested they might, but that actual research on that issue should be conducted.
I take it back, you are trying to be deceptive.
it showed but didn’t prove. observation vs causation
…I’m done.
You’re the one who stated “statins improved outcomes.” That is a statement of causation. Observation is stating “statin users had a lower cumulative incidence of” outcomes – i.e., the words of the researchers. The researchers drew no conclusions as to whether the statins themselves were the cause. Thus, they noted a correlation, but did not conclude there was causation.
I take exception to be called deceptive when I’m simply pointing out the language of the researchers.
As a really smart guy once said, the plural of “anecdote” is not “evidence”.
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The issue of association vs. causation is often confused, even by researchers. The real problem with observational studies such as those above is that they can suffer from what is called “selection bias.” This means that people who selected to take a statin may already have made choices to take better care of themselves. If they did and that caused the differences, then this study while finding an association obviously did not find evidence of causation.
A good way of asking yourself whether the association might be a result of selection bias is to turn the finding around to “good outcomes associated with higher statin use.” Actually, this might make sense, which suggests a potential problem with selection bias.
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Are you suggesting that I don’t understand the difference? I think my responses demonstrate that I’m not the one who’s confused.
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No, but even professionals who claim to know the difference don’t actually know the difference.
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