I went to my local GP yesterday afternoon (ie. not my diabetes specialist doctor) as I had to have my medication reviewed by him due to the fact that he authorises my repeat prescriptions. He said that I really should be taking statins as (in his words) “all diabetics should really be on statins”.
I don’t know what to do though as my cholesterol was 4.3 mmol/l (167 mg/dl) at my last test in November 08 which is well in the normal range. Should I wait to see my diabetes specialist doctor at my appointment in April, or should I just start taking the statins now and then speak to the doctor in a few months?? I’d really appreciate your advice!
From what I understand, statins are extremely low risk and have a large benefit for people already at risk for artery disease (i.e. us diabetics). Many physicians joke about statins, saying they should even be in the drinking water. Even when your cholesterol is in the normal range, your risk goes up as your cholesterol goes up, so lowering it even more can’t hurt.
My cholesterol levels are very low – below 100 (that’s the total number), and that is with the help of statins. My endocrinologist, gp and cardiologist all recommend that I keep the cholesterol as low as possible, well below the numbers recommended for people not otherwise at risk for cardiovascular problems.
I’ve been on statins for 8 years, without any adverse effects (yet). I did not have high cholesterol before the statins, and I have only gotten better with them.
So long as you do not have liver problems and are otherwise being monitored, I would go along with the recommendations from your GP, subject to your endo concurring.
The issue with muscle weakness and joint pain that you mention does occur, but is relatively benign and can be corrected for by changing the prescribed statin, reference here: http://www.medscape.com/viewarticle/538448
As for your liver disease, this is also relatively rare although it can be very debilitating. I’m not sure when you were first prescribed statins, but doctors know to test for liver enzymes soon after prescribing to test for any rise in liver enzymes that could indicate pathology.Just like in your case, a switch to a different statin helps alleviate the problem.
Statins can also cause problems in pregnant women because it robs cholesterol from enzymes that need it to synthesize developmental factors. This depends a lot on the cholesterol level that the person who is on statins is maintaining.
The last problem I’ve heard of with statins is neuropathy which should be checked for during any doctor’s visit and the statin can be changed.
The risk of these problems occuring increases with quantity of statin given. Because she has a normal cholesterol level to begin with, her doctor would likely prescribe a low dose.
I assume that the physician explained the common side effects and told Sam to contact them if there were any issues. Statins are one of the most prescribed classes of drugs and there is a lot of health data available to back up their efficacy and value, especially to diabetics who should take any steps they can to lower heart risk. Its unfortunate you had a bad experience, but lets not generalize that the unlikely will happen to everyone, and lets not insult other people’s intelligence; I wouldn’t write a post with information synthesized from my own imagination.
I think that there are a couple of things that need to always be taken into consideration:
We are all different and have different experiences with the plethora of medications that are available to us.
We each always need to be our own best advocates and medical professionals. No one knows the ins and outs of our respective bodies, treatments, insulin and dietary regiments than we do. Medical professionals always need to be challenged.
What works for one person may not work for another, and what has complications or side effects for one of us may not have the same result for another.
Diligence, always.
All that having been said, my personal experience with the statins has been positive. No liver issues (I have blood work done quarterly) and no muscle weakness. We each can only speak for ourselves.
IMHO Every medicine, has risks. I think statins can be a good course of action in keeping your cholesterol within tighter “normal range” and with diabetes, our desired normal range is actually lower then those without diabetes, plus given the potential for heart risk taking a proactive approach to staying healthy is worth investigating. If you have no issues on the medicine, then great for you. If you have issues than you find a different way ward off problems in the future. Good luck!
Hope the same terminology is used in Canada. Dont know much about livers. Had some problem when I was 12 not sure what. I can’t survive metformin for more than 3 weeks think the liver does not like it but have no objective data. Again I am not sure you want objective data for liver damage. My friend Cox said you can live with diabetes but he said you cant live without a liver.
Before the last lipids test I deliberately ate a high fat low carb diet including a lot of cheese. and surprisingly the lipids were not any worst. I wonder if it is worth the risk to your liver or perish the thought of the muscle wasting disease by taking the statins to improve LDL a bit. Actually a bit better BG control may be as effective.
I think you warning people about the liver issues is very good even if it may affect only 1% of the people taking statins. Because the outcome liver damage is so desastrous.
Thanks for all your posts - they’ve been really useful as they always are on TuDiabetes!
I think I’ll take the statins as I’d rather ward off long term heart problems which as many of you have said are the biggest killer of those with diabetes. As for dosage, I’ve been put on 1 40mg tablet of Atorvastatin a day (is that a low dose??).
Dave: I understand what you’re saying about side effects, and I’m sorry you’ve had such problems but as others have said, every drug we take has a huge list of potential side effects but, thankfully, these are rare.
I will, of course, make sure that things like my liver function are monitored - in fact, I’m due to have blood taken in April by which time I’ll have been on statins for a couple of months.
I have read references lately to test results showing statins to lower inflammation so there is thinking that they are potentially helpful in warding off other health issues as well.
I took statins since 2003 when I had a big heart accident, each day 40 mg. My liver is well. Before my open-heart surgery I had no problem of cholesterol, very normal tryglicerides 'french sorry)… Dave, how long did you take statins? I’m afraid! tank you.
Hi Dave,
Of course we don’t think you’re totally “anti-statin” - it’s just you’ve had a bad experience with them and want to inform people that they’re not all a bed of roses. That’s understandable and thanks for the information. I’ve read the Wikipedia entry about the statin that I’ve been prescribed and although I’ve decided that I AM going to take it, I’ll take your advice and ensure that I have the reccommended liver function blood tests while I’m on them. The last thing I want is to have problems with my liver due to statins, trust me!!
Thanks again for all your advice
Wow. You sure know an awful lot about statins and diabetes which brings me to my only question – not meant to be combative – But, if you knew all of this, why did you bother asking? It sure seems to me that you were out to pick a fight about it just to air your disagreement with three doctors.
Lois La Rose
Milwaukee, WI
P.S. I’m still on statins after bring my cholesterol number down because my “good” cholesterol number needs to go up.
An important point, in response to liver damage due to statins, is that no one, I repeat, no one has ever died from statin-induced hepatotoxicity. As Dave indicated, stopping the med always returns the liver enzyme levels to baseline. This is in contrast to drugs like Tylenol or Rezulin (the 1st drug of the TZD class that are now represented by Actos and Avandia) which can cause irreversible liver failure and death. The most dangerous side effect of statins is not liver related, but rhabdomyolysis (muscle breakdown), which can cause kidney failure and death. This is why cerivastatin (Baycol) was pulled from the market, as it caused a disproportionate amount of this side effect. That said, rhabdomyolysis is EXCEEDINGLY rare and 100% preventable, if the symptoms are appropriately recognized.
Certainly, no one wants to have a drug side effect, but statins have clearly been shown to lower the risk of the most common cause of death in type 1 and type 2 diabetes, vascular disease. To put it bluntly, the worst side effect of a statin is that you might live longer!
For Sam, the question of whether someone with type 1 diabetes and a normal cholesterol level should be on a statin is controversial. Clearly, as a population, people with type 1 diabetes have increased CV risk, but that may not apply to the individual person. It’s very hard, in the absence of kidney disease, to identify people with type 1 who are at high risk. This is because all of the prediction methods (ie the Framingham risk calculator or UKPDS Risk Engine) don’t work for type 1. Also, most people with type 1 have very high HDL cholesterol (good cholesterol), however this HDL may not be as protective as HDL in people without diabetes (insulin raises HDL so taking insulin REALLY RAISES HDL).
Most GPs simply see diabetes =statin. I don’t know if that’s correct, but I err on the side of taking it because the benefit far outweighs the risk, in the vast majority of people. That said, it is a decision that is not urgent and waiting to discuss it with your endo won’t do any harm. He may be able to better quantify your risk for you, than the GP who says “everyone with diabetes needs a statin.”
