T1 Diabetes and Statins

Hi everyone,

My partner is a T1 diabetic for the last 29 years. He is 39 years old. He is generally in good health. Over the past year or so he has sometimes gotten cholesterol tests back which are according to his drs. normal if you don't have T1 diabetes, but they all suggest he should go on statins.

I (and he) are unsure how to proceed. My first instinct is that the drs. don't have any skin in the game and we should do more research and gather some data to see if this is a good idea. After all he will be taking this medication for a long time if he starts.

Do any of you have an opinion about long term use of statins? Did you ever have to make a similar decision? Thank you for reading!

Below are numbers from one of his tests:

Cholesterol, Total 187 <200 mg/dL Desirable Triglycerides, serum 84 <150 mg/dL Desirable Cholesterol, HDL 51 >39 mg/dL Acceptable

LDL Cholesterol 119 <130 mg/dL Near or above optimal Chol HDL Ratio 3.7 <6.0 Non HDL Cholesterol 136 <160 mg/dL Near or above optimal

I am in the same boat. My LDL cholesterol was 2.7 (104 in U.S. measurements), my HDL was 1.5 (59 in U.S. measurements), and my total was 4.6 (178 in U.S. measurements). I don't remember what my triglycerides or the ratio was but both were well within the normal range.

I just got a new endo and he said these numbers would be fine for a non-diabetic but people with diabetes should have their LDL below 2.0 (70 in U.S. measurements). In fact, every doctor I have seen for the past five or so years, endo or not, has mentioned cholesterol medication even though my cholesterol is "normal" for someone without diabetes. I reluctantly accepted a prescription for the smallest dose of Crestor, but I haven't filled it (it was prescribed almost a month ago).

I read up on what foods can help lower cholesterol and will try those as well as continue to lose weight, and I will tell him this at the next appointment. I just am NOT comfortable taking medication for something that is apparently normal when I am only 30 (if I was 50 I might reconsider).

So I am hoping my cholesterol is lower at the next appointment just form dietary changes and exercise. My endo said he didn't think it would be possible for me to get my cholesterol that low without medication.

Woops - sorry about this. The test results were not formatted well.

[Cholesterol, Total 187 <200 mg/dL Desirable], [Triglycerides, serum 84 <150 mg/dL Desirable] [Cholesterol, HDL 51 >39 mg/dL Acceptable]

[LDL Cholesterol 119 <130 mg/dL Near or above optimal] [Chol HDL Ratio 3.7 <6.0] [Non HDL Cholesterol 136 <160 mg/dL Near or above optimal]

Hi Jen,

Interesting. Thanks for replying, its very helpful to know what people are thinking about this. My partner also happens to be not at all overweight (maybe a little underweight for his height) and we eat a supposedly very healthy diet - barely any sugars and low on carbohydrates, so we don't fell we can even do anything more in this direction.

Sometimes I suspect that the endos and drs have all been fed this line about having to go on statins and they just repeat it. We need a good way to convince ourselves whether this is really the right thing to do or not, with all the evidence in hand.

I've been on statins for the past 5 years with no side effects. My endo suggested increasing my dose when my LDL came in at 95 at my last appointment because he said he likes to be aggressive on cholesterol because he's seen the devastating results of strokes and cardiac events on people with diabetes.

Thanks for your reply still_young! Can I ask how old you are? So it sounds like your number of 95 LDL is already rather lower than what my partner has - 119 LDL.

My diet is already quite good, but I looked up foods that specifically help lower cholesterol and am trying to eat more of them. I don’t know if it will work, but we’ll see in a couple of months.

I'm 62. From what I've heard, the current standards would consider an LDL of 119 to be on the high side even for someone without diabetes.

Indeed, it is a bit on the high side. I am unsure what to think about this: I have read there are two kinds of LDL and one of them is bad and the other good. I have no idea which kind this one is. Secondly, I wonder if this is somewhat high because he eats a lot of eggs (2-3 whites and 1-1.5 yolks every day). I am going to try to look at a more numbers if he has them for the LDL values.

Diabetics are at an increased risk of a stroke or heart attack. Therefore, the medical community has lowered the recommend goals for blood lipids for diabetics. Statins are also supposed to be helpful to kidneys.

I think if a diabetic is otherwise healthy and has cholesterol levels that would be in range for an average person, then it is their choice if they think a statin would be beneficial. One other note: if your partner chooses to start taking statins, then his medical team will not want him to stop taking it without very good reasons.

Right, I understand your point. What foods did you learn lower cholesterol?

Definitely try the no eggs routine for a month and see what changes! I was surprised at the difference I had.

Yeah, that is certainly something to try. Unfortunately we'll have to balance it out with trying to avoid carbohydrates...eggs are one of the things he can eat a good amount of since he also seems to be celiac/wheat intolerant. We do eat a lot of fish, but fish for bfast, lunch and dinner might be too much :)

Capin101, that is good to know and take into account for sure. Do you have references/papers which show the arguments for deciding to lower the recommended goal? Obviously, intuitively it sounds like a good idea. I am just wondering exactly what the science is.

I’m curious to know if your BG was high at the time of your labs? I read that if you are low on insulin at the time of your labs that your cholesterol will also be high. It said that as soon as you inject insulin your cholesterol will drop. Does anyone know if there is any truth to this???

I eat EggBeaters every day. No need for yolks except on special occassions.

High blood sugars can cause lipid abnormalities. Your liver works overtime to convert extra blood sugar into triglycerides and blammo, abnormalities.

This whole cholesterol thing can be confusing. Yes, as diabetics we are at much greater risk of heart problems. But it turns out that much of the risk is actually independent of cholesterol. Despite this, medical panels have decided based on "reasoning" (not evidence), that diabetics should have more aggressive lipid goals. And this drives an effort towards what I call statination.

In my view, your husband has perfectly normal lipids and there is no evidence that lipid lowering is beneficial. There is in fact evidence that total cholesterol levels below 160 mg/dl result in excess mortality. But most of all, statin side effects are routinely downplayed. Some studies suggest that as many as 20% of us suffer side effects, some of them quite dangerous. I personally found that I could not tolerate statins.

Statins are major profit centers. I'm not clear they have saved lives. I would encourage you to become smart about cholesterol, heart disease risks and the evidence on statin use and make your own decision.

One thing to remember is that most (all?) of the studies linking diabetes, cholesterol, and heart disease are based on people with Type 2 where high cholesterol and other heart disease risks are often part of the disease process not a complication of diabetes.

I am not saying we Type 1's are immune from increased risk for heart disease because high blood sugars can damage our circulatory system. And there are some of us who have characteristics of Type 2 along with our Type 1.

However, cholesterol meds are not without side effects for many people and I personally would think twice about taking them. Some doctors feel that everyone with diabetes should take statins and I feel fortunate that neither my internist nor endo have ever suggested I take them. My husband (non-diabetic) has permanent muscle damage from having taken statins and I would need a lot of convincing to ever take them.

I do wish that there were some studies on the risk of heart disease for "well-controlled" Type 1's who have no apparent signs of metabolic syndrome.

I am a T1 LADA, diagnosed at 46. I took Statins for a couple of years and quit taking them after reading on the internet that most PWD's on Statins don't actually need them, The risk of stroke and heart disease is directly related to how well you control your BG. The worse the control the greater the risk. So if your HbA1C is between 5 and 7 then you've got good control and your risk of Heart Disease is about the same as an average non PWD and so statins are not necessary.

Also there are now studies showing that there are serious side effects related to long term use of statins. Long termin is considered to be anything longer than two years.

I recommend you also search for statin references on Tom Naughton's web site http://www.fathead-movie.com He has some interesting articles about Statins.