I recently moved and had to switch Endos. He gave me some recommendations right off the bat that I hadn’t ever heard before; at least not for people with similar stats to mine. He suggested taking (starting now and for the rest of my life) a baby aspirin and Zocor (statin) ever day.
My stats are these: I’ve had T1 diabetes for about 2 years. Age: 35. Good blood pressure. A1c 5.3. Cholesterol 17 (Tri:28, HDL:83, LDL:84), which I thought was pretty-darn good 
He said that it didn’t really matter if I had good control and seemed to think that the higher risk for diabetics to get heart disease was a reason for all of us to take these medications every day. I’d rather not. Has anyone else heard this? Does anyone else without other risk factors take a statin and aspirin every day? He also mentioned taking fish oil instead if I really didn’t want to take the statin. Anyone else on a daily fish oil regime?
My endo has done the same thing, and much of this has been perpetuated by the drug companies who want every human being to use statins for life (that’s a nice revenue stream, especially while they still enjoy patent protection on many statins). However, I think new research raises legitimate questions on whether statins are really a useful for people with diabetes (especially those with type 1 who do not have hypertension). You can and should press back on this issue; for example, we know statins cause muscle deterioration in many people (and the heart is a muscle) and may not really prevent cardiovascular disease as the promoters seem to suggest. Also, the aspirin element is also questionable for many of the same reasons. You have the right to question being prescribed yet another medicine you’ll be expected to take for perpetuity!!
For me it wasn’t my endo but my GP who put me on a similar regimen (Baby Aspirin and Lipitor). My cholesterol was “elevated”, or so I was told BUT these days in my GP’s words (and my Endo’s) it’s “Perfect”…Still on the meds though. My GP is big on the “natural” stuff too…Cinamon for a while, Ginger (for Vertigo), Alpha Lipoic Acid for a while…I’m a walking medicine cabinet! When they ask what I’m currently taking I usually respond, "What was I on last time I was here, I’ll tell you if there are any additions or subtractions…easier that way.
I take a statin (Lipitor, 10 mg) on the advice of my endo. I also had no risk factors other than diabetes and my numbers were all fine, but I didn’t push back because I trust her. According to her this is a recommended prophylactic treatment protocol for all Type I’s.
I have recently begun to suspect that the pharmacies are pushing this idea based on a story I heard on NPR where some drug company flack said something to the effect that ‘everyone should be on statins all the time.’ Huh?
Scott’s statement that statins cause muscle deterioration in many people also gives me cause for alarm, so I’m going to look further into this for myself. If anyone has a reference point where I can look, I’d appreciate it. Here’s one article I found which questions whether diabetes alone is enough of a risk factor to justify a statin regimen: http://diabetes.webmd.com/news/20080110/statins-for-all-adults-with….
And here’s what the Mayo Clinic says about statins - including that you should be prepared to be on them for the rest of your life!! WTF?? I’m talking to my endo about this right away.
http://www.mayoclinic.com/health/statins/CL00010
One thing I know for sure about statins is that if you like grapefruit you need to be careful about which one you use. Grapefruit can prevent some drugs from metabolizing.
As for the aspirin, I take a baby asprin every day (81 mg). But my understanding is that the aspirin regimen works in males and has no benefit for females. But it couldn’t hurt, I suppose.
Terry
I take 10mg of Zocor which I am not overly thrilled about. It is bad enough to be taking Synthroid, Zyrtec and Insulin on a daily basis. I have read both sides of the argument but what I need to do is see what other options exsist. Can any one comment on successful alternative to lowering your cholesterol that does not require taking something worse than a statin?
I am on a statin (10mg Lipitor daily), in the form of Caduet, which is a combination of Lipitor and a hypertension drug. I also take Ramipril 20mg per day, all on a preventative basis. I have seen the studies on the effectiveness of these drugs and believe that, while the issue may not be settled completely yet, there is evidence that statins do provide a level of protection against heart disease and possibly other conditions that tend to affect type 1s. If your dose does not cause side effects and prevents or delays complications then I see no problem with taking it. I understand there are risks in taking all drugs, and I have no problem with a pharmaceutical company making money off of a drug I purchase to improve or protect my health.
The one thing I do about the Lipitor is to take a CoQ10 supplement, as statins can significantly reduce your body’s production of that antioxidant. The muscle issue is a very rare one, and I have gained significant amounts of muscle while taking Lipitor.
I don’t have a problem with drug companies making money off a drug I purchase,either.
I do, however, have a problem with drug companies pushing a drug on me if I don’t need it.
David,
The first link in my post above offers alternatives to statin therapy. Here it is again:
http://diabetes.webmd.com/news/20080110/statins-for-all-adults-with…
About statins: My endo tried to make me take statins. I would not because I have excellent cholesteraol and trigycerides and no known heart disease in my family. I also have normal blood pressure. I tried both Lipitor and Zocor and they both lowered my Bp too much and I got headaches. I took a c- reactive protein test which measures inflammation in the blood vessels and ccame out with a .2, which is negligible risk… My internist says this is a better indicator of hear diease risk. So I was “non-compliant” and still will not take statins. Is it true that they can pose a risk to your liver?.. I think I read that somewhere… So I do not take statins and niether my endo nior my internist hassle me about it anymore. I think some doctors truly beleive that you must put all diabetics on statins. By the way, my bad cholesterol is 51 and my good cholestorol is 118. Without statins I use omega 3 with flaxseed oil, tablets three capsules a daqy, which does the trick for me I will NOT take statins.
Julie-
“Statin rage” is an article written by David Mendosa. I think you will find it interesting. I know I did.
I agree with Scott, if you aren’t sure why your taking a certain drug…Ask. You have to know what’s going in your mouth and why it’s going there.
When I pressed my Endo to explain why I would take a statin when I had good cholesterol, he mumbled something vague about inflammatory factors. Thanks to everyone’s input, I now think I know what he was talking about….and there may be some validity to being concerned about this as a diabetic. But…to take statins forever without ever even getting the CRP test? I’m with Terri here, wtf?
I’m going back next month and am going to request the test before I make a decision.
I used to work for the Pharmaceutical industry. It’s not that I have a problem with them making a profit off of a drug, it’s that I doubt the long-term studies. I have little faith in the FDA approval process and as far as I’m concerned, the FDA seal of approval just means that a drug is now available, but not that’s it’s necessarily safe. ……and Aspartame doesn’t have any long-tem side effects right?
It does seem to me that there could be some benefit (and no risk) to adding a daily supplement with Omega 3 fatty acids and flaxseed oil. My endo said I could do this as well but his dosage information was again vague (take 8, 1000Mg fish oil capsules/day). My mistake not to read it completely while I was still in the office. A Mega-gram is 1,000,000 grams. That can’t be right…but even 8,000mg a day seems like an awful lot. Online, it looks like they recommend a dosage by the amount of Omega 3’s, not the amount of fish oil. Anyone have a recommendation on an Omega-3 dosage for diabetics?
Aspartame, in the amounts found in diet sodas and other such drinks, does not have any long-term side effects. All substances can be toxic. The dose makes the poison. If you were to drink 50 or so diet sodas per day, every day for years, then you might start to see some signs of aspartame toxicity. Drink several gallons of water in a very short period of time and you will die or come close. But water is not harmful over the long term in proper amounts.
The FDA approval process is a lengthy and thorough one. No process is perfect, but some of the best diabetes treatments available have been proven efficacious through this process. Why do you doubt the long-term studies? You are correct in that all drugs, including those with FDA approval, carry risks. It is up to you to weigh the risks in a rational manner and come to a decision as to whether the potential benefits outweigh the risks (and if the risks can be mitigated if unavoidable).
I have no problem with taking statins forever, just like I have no problem with taking fast-acting analogs that mimic the action of insulin my entire life. Apidra isn’t insulin, and neither is Novolog or Humalog, but we take them because they were demonstrated to be safe and effective via the FDA approval process.
I think Julie questions this because the FDA approval process is not as clear-cut as you are suggesting. Just last month, it was revealed in a U.S. Federal Court that Pfizer had suppressed the publication of studies which presented a drug in a less favorable light; oftentimes only those studies which support the drug company’s business case ever make it to a scientific or medical journal; the rest are conveniently never released. Furthermore, we have seen a number of examples – need I remind anyone of the type 2 debacle with Avandia – which was later proven to actually increase cardiovascular risk in spite of meeting the “surrogate endpoint” of reduced HbA1c required by the FDA for approval as the primary approval criteria. Those results were only revealed after the drug was approved – and only because of an agreement the manufacturer made with the New York State Attorney General to publish ALL the study results on its website that lead Dr. Steven Nissen at the Cleveland clinic to find them. Long-term follow up studies (10+ years) are rarely (if ever) required by the FDA. I would also call attention to the numerous organizational issues with the FDA.
For example, last December, The New York Times reported that the FDA is desperately short of money and poorly organized, which is putting people’s lives at risk. This was derived from a report entitled “FDA Science and Mission at Risk” published by the FDA itself which reported that the Agency is desperately short of money and poorly organized, which can be found at the Food and Drug Administration’s website, highlights the numerous problems at the FDA.
You’re right that no process is perfect, but I think you’re putting a little too much faith in the FDA!
I don’t have any faith in the FDA. My expectations with regards to them are based completely on their track record. There are certainly instances of failures, sometimes spectacular ones. This is true of just about every human institution. So my expectations are tempered by reality- looking at the track record of FDA-approved treatments, the vast majority of them work safely and effectively.
Personally, I take the decision to start on a new drug very seriously. I research it as much as possible, monitor myself closely for side effects, and I am lucky in that my health care team is even more zealous than I am in watching for problems. I do not depend solely on FDA approval, but that approval carries a lot of weight in my decision.
If a drug was rejected the FDA then I think most of us would probably avoid it, despite their present shortcomings which you have described accurately.
I read both of the articles that you posted and both were pretty good. I can’t say that the alternatives are any better than what I am taking. Time will tell.
Thanks,
Dave
It seems that the risk of CHD or Stroke is generally considered to be 2-4 times higher for diabetics, however, I’m having a hard time finding statistics for people that specifically have T1 diabetes, so it seems that we’re usually lumped in with the other %90-%95 of diabetics (T2) that are also much more likely than the average Joe to be overweight, have bad cholesterol, and high blood pressure (75% of adults with self-reported diabetes had blood pressure greater than or equal to 130/80). Is it any wonder then that diabetics are more likely to die of CHD and stroke?
I did find the following facts released in the CDC 2007 National Fact Sheet:
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In patients with type 1 diabetes, intensive insulin therapy has long-term beneficial effects on the risk of cardiovascular disease.
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Blood pressure control reduces the risk of cardiovascular disease (heart disease or stroke) among persons with diabetes by 33% to 50%, and the risk of microvascular complications (eye, kidney, and nerve diseases) by approximately 33%. In general, for every 10 mm Hg reduction in systolic blood pressure, the risk for any complication related to diabetes is reduced by 12%.
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Improved control of LDL cholesterol can reduce cardiovascular complications by 20% to 50%.
If you add up the reductions for having good BG control via intensive insulin therapy, low blood pressure, and good cholesterol, then aren’t your chances of dying from CHD or stroke much lower that the “2-4 times higher that non-diabetics?” I think if you add to the above stats a person’s hs-CRP result, then this is the info that should be used to determine which diabetics should take statin/aspirin therapy instead of the one study that seems to have justified statin use for all (their results would even cause me to hypothesize all humans, not just all diabetics!). I’ve decided that unless the hs-CRP test I’m requesting is high then I’m going to stay off the statins…at least until menopause 
By that time, I’m sure there will have been much more research on the effects of statins. Thanks for everyone’s opinions.
A few relevant links you might be interested in:
Diabetic Clinical Practices recommendations (regarding statin use in particular, 2004).
I don’t take fish oil. I hear people can burp it up all day, and well, that’s just gross. If you want to increase your omega-3 intake, start eating more walnuts, and start using flaxseed meal and products with flax in it (there are breads, cold cereals, hot cereals). Then eat some salmon or similar fatty fish a couple of times week.
I do take Lipitor, but my cholesterol had gotten fairly high. I was taking baby aspirin, but I got lazy and stopped.
Also, once I got my BG’s under control and with the help of an ACE inhibitor, all the protein in my urine - there was A LOT - seems to have cleared up so it’s almost in the normal range again.
Trader Joe’s also sells flaxseed oil, which is a great source of Omegas and has none of the issues some people have with drinking fish oil. It has a neutral taste. I usually put a tablespoon into my protein shake after my workouts. Keep the bottle in the fridge and out of the light.
Are you taking an ACE inhibitor?
When I was first diagnosed, my GP wanted to put me on an ACE inhibitor, a statin, and (I believe) baby aspirin; he deferred the decision to my endo, who felt that there was no particular need to do so. You have to balance the risk of heart disease (relatively negligible for a younger person with good blood pressure, etc.) with side effects (and I have no idea what the side effects of the statins are.) I do know that my father, who’s an MD with endo training, did not like the idea of sticking me on all that stuff in addition to the insulin - and he worked for big pharma, so he has a better idea than most what happens there.
Which is the long winded way of saying, no statin, no ACE inhibitor, no aspirin.
I’ve tried to take statins off and on. Every once in awhile my doctor tries to get me back on them for the health benefits. I get so tired when I’m on them (probably low blood pressure) that I can barely function. Note to self: Don’t let doctor talk you into this again.
I do take daily aspirin (81 mg) and fish oil (about 2000 mg) daily. I freeze my fish oil capsules and take them before bedtime. Don’t have any burping problem. Not that I’m aware of anyway. BiosLife has a product that lowers cholesterol. My dietician has researched it and does recommend it to anyone wanting an alternate method of reducing cholesterol. I’m thinking she said it would cost about 90 dollars a month. Doubtful that insurance would cover it.