Cholesterol and Triglicerides
tsazani
Posts: 830 Member
I'm amazed that this hasn't been discussed in this group. Your lipid (fats and cholesterol) profile is the third most important aspect of your DM2 control after your A1c and blood pressure.
It's FAR MORE IMPORTANT than post-prandial BS spikes that some here seem to dwell on. For what reason? I don't get it.
As a DM2 patient, I will never be able to ditch my statin medication and if you're smart, you won't either. The diagnosis of DM2 is a "heart attack equivalent". Current treatment is to give the DM2 patient enough statin med to drive the LDL (bad cholesterol) level to 70 or less.
IMPO, almost all DM2 patients should take three meds (if tolerated) no matter what the A1c and BS levels are:
1. Metformin
2. Statin
3. ACEI or ARB (a type of blood pressure medication that offers kidney protection).
Pretty similar to a heart attack patient, there are three meds that all S/P MI patients should take for life if tolerated:
1. Statin
2. Beta blocker
3. Aspirin
It's FAR MORE IMPORTANT than post-prandial BS spikes that some here seem to dwell on. For what reason? I don't get it.
As a DM2 patient, I will never be able to ditch my statin medication and if you're smart, you won't either. The diagnosis of DM2 is a "heart attack equivalent". Current treatment is to give the DM2 patient enough statin med to drive the LDL (bad cholesterol) level to 70 or less.
IMPO, almost all DM2 patients should take three meds (if tolerated) no matter what the A1c and BS levels are:
1. Metformin
2. Statin
3. ACEI or ARB (a type of blood pressure medication that offers kidney protection).
Pretty similar to a heart attack patient, there are three meds that all S/P MI patients should take for life if tolerated:
1. Statin
2. Beta blocker
3. Aspirin
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I take:
metformin
statin even though my chol was like 160 and my other readings were all fine. I know this is a lifetime thing.
Somewhere I have the name but after we work out the amaryl dose then it's on to the kidney/bp one.
I also take a baby aspirin daily
I have always watched my kidney function and liver functions. Kidney has always been fine, liver is somewhat off but I guess that's because I take so many drugs and I was told that so many years of synthroid will throw things off a bit.
But I do always fret about my BG too. I think that for now, my dose of amaryl is working ok. I worry it will exhaust my beta cells but my bg is doing much better than it was.0 -
"IMPO, almost all DM2 patients should take three meds (if tolerated) no matter what the A1c and BS levels are:
1. Metformin
2. Statin
3. ACEI or ARB (a type of blood pressure medication that offers kidney protection)".
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I disagree. Diabetes is most definitely NOT a death sentence. I've been Type II diabetic for 10 years and have never once heard this. Heart disease and diabetes is prevalent on both sides of my family so my doctors watch me like a hawk and I'm VERY proactive with my health. I read, and understand, all my labwork before I even show up for my appointment and I diagnose myself only to have the doctor confirm it. That may sound arrogant but I choose to call it being educated and proactive. My endocrinologist is one of the top in his field in the tri-state area. My doctors have always had the belief that less is more, meaning if you can control it with diet and exercise, this is the ideal solution. I had pancreatitis in 2008 and it's believed that the statin I was taking at the time was the cause. I wouldn't advise anyone to take medications just because they were given a diagnosis, especially if their labwork comes back fine. The side effects are too great. Frankly, you couldn't pay me enough to go back on a statin after what I had experienced. But the thing is, it's such a rare side effect, less than one percent, and very difficult to prove, if not impossible. You just don't know. I'm not only referring to pancreatitis. There are MANY serious side effects that go unreported each year and we the public are ignorant to this information.. So why put manmade chemicals into your body if you don't need them? It's one thing as a precaution but I think this might be a little too cautious. If one consumes a proper diet and exercises 30-45 minutes 5 days a week there is no need to poison their body with unneccesary meds. I believe what's more important here is patient awareness. Patients need to educate themselves regarding their illnesses and they need to be their own advocate. Sorry if this is a little strong, I'm very passionate about this subject.0 -
My unmedicated a1c is 5.6. Average BS is 90 2 hrs after eating. I'm on low statin dose and bp med for its kidney protection. Don't really need metformin, knock wood. My HDL/LDL ratios are actually reversed from the normal. HDL is typically over 90, approaching 100 so my total cholo numbers are, to say the least, misleading. I watch myself like a hawk: lots of low glycemic stuff, rigorous controlled diet, exercise 6 times a week. I somewhat disagree with you in that, under my circumstances, I see no need for metformin.
The only ***** I have is that Lipitor now costs more per ounce than gold, so I'm moving to a generic. Haven't started it yet, so we'll see what happens.0 -
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Oops, I forgot the FOURTH med every DM2 patient should take: a baby aspirin (ASA) every day.
So, here are the four necessary (again, if tolerated) meds every DM2 patient SHOULD take even with perfect lab tests.
1. Metformin
2. Statin
3. ACEI or ARB
4. ASA
DM2 is not a death sentence. It is a CHRONIC and PROGRESSIVE disease. Any DM2 patient who thinks they return to normal just because their lab numbers come back normal is seriously deluded.
Fatman's rule #1: "The patient is the one with the disease." Another old standby is: "You can lead a horse to water but you can't make him drink."
As a physician, I've always followed these two rules.
Note: "The House of God" by Shem is the book where the Fatman appears. It is the underground bible for internal medicine specialists.
What exactly are the benefits of taking these meds if labs indicate otherwise?. Educate me so I can decide if the benefits outweigh the risks So far, no doctor has been able to do this, nor do they want to b/c they believe medicine is a last resort. Yes, the patient is the one with the disease. It's their body and they should feel comfortab;e with what they're putting into it. I'm sure it's frustrating seeing noncompliant patients on a daily basis. I was one of them. But I'm just not understanding your point of view on the meds.0 -
The change of having a heart attack is 4 times higher for diabetics. High LDL cholesterol is associated with a much higher increased rate of heart attack and lowering LDL with statins lowers the risk of heart attacks. (Now if you questions these facts, well do whatever you want to do, your body your health, your choices).
Current recommendation is to lower LDL to below 100 and 70 if you are diabetic.
I am taking Crestor, a statin, which lowers my LDL to 80 from 150, and have no side effects in the last 8 years.
Basically, the way I see it, there is a much higher real risk of a heart attack and potentially a small chance of side effects of medication. Easy choice the way I see it.0 -
The change of having a heart attack is 4 times higher for diabetics. High LDL cholesterol is associated with a much higher increased rate of heart attack and lowering LDL with statins lowers the risk of heart attacks. (Now if you questions these facts, well do whatever you want to do, your body your health, your choices).
Current recommendation is to lower LDL to below 100 and 70 if you are diabetic.
I am taking Crestor, a statin, which lowers my LDL to 80 from 150, and have no side effects in the last 8 years.
Basically, the way I see it, there is a much higher real risk of a heart attack and potentially a small chance of side effects of medication. Easy choice the way I see it.
There is no question as to whether to take the meds to bring your numbers within the normal range. what I'm questioning is why to continue taking the meds if your labwork comes back fine and you're doing everything you should be doing to keep it that way, i.e. proper diet and exercise. I'm not trying to have an arguement. I'm simply playing devil's advocate and trying to understand the benefits of medicating your body if labwork indicates otherwise.0 -
I'm curious. Are you saying I should be taking these medicines even though my BP falls squarely in the normal range and I have, according to my doctor, "the best cholesterol I've ever seen in a diabetic patient and one of the best I've ever had for a man your age, period?"
My doctor took me off metformin yesterday after having an A1C of 5.1 both yesterday and in January. Is that a mistake?
I can maybe see your point on the metformin, but I have a hard time wrapping my head around swallowing drugs to treat problems that I do not yet, and may never, have.
I'm not saying you're wrong, and I'm not opposed to taking medication that is necessary. I'm just wondering why you feel these are necessary if the problems they treat have not presented themselves?0 -
I have to agree that if BG is in control with diet then met is probably not needed as long as it remains in control.
High chol runs in my family. My overall chol number is good but my LDL and HDL are normal but on the bad side of normal.
And although my bp is really good and always has been I don't want to have to worry. I have a long time to go and am willing to take whatever I need to stay healthy.0 -
I agree. If your cholesterol, glucose or blood pressure numbers are fine, I would not take medication. But if they are not, I would take them.
The only exception might be a low dose of aspirin, like 100mg per day. There are an increasing number of studies showing that this might be beneficial.0 -
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I completely understand the desire to not take any medications. I have that same FANTASY.
However, I'll ask a simple question. Do you wish to reduce the probability of small artery (eyes, kidneys, others) or large artery (heart, brain, lower legs. others) disease going forward?
If yes, take the four meds ANY competent physician would agree with. If not, don't. Remember the Fatman's #1 rule.
If anybody would like it, I could list the rest of the Fatman's rules in a new post. Many may not like them <grin>. But to many doctors, they are really funny.
Yes, I do wish to reduce the probablility but you still haven't explained the benefits of the meds as opposed to clean eating and exercise. My doctors are VERY competent. Not all doctors agree on treatments. Nowadays many doctors are moving on to a more holistic approach. I don't really think it should be generalized in such a broad statement. If it's your opinion, that's great. But to say "ANY competent physician would agree"? Again, I'm not trying to argue. Just asking for the proof to back up what you're saying. It doesn't really matter at this point. I think it's safe to say we should agree to disagree. I'll pass on the Fatman's rules. I'd rather keep the respect I currently have for my doctors. Ignorance is bliss in this case.0 -
If that is the logic behind it, you can carry it even further. I can reduce my probability of being injured/killed in a car accident by taking the preventative measure of never getting in a car again. I can reduce my probability of being struck by lightning by taking the preventative measure of moving out of Florida, the lightning capital of the world. The list goes on and on.
I guess it comes down to a personal decision on whether or not the potential side effects of the drugs are worth the reduction of the probability of developing a disease an individual does not currently have.0 -
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Hi Tsazani, sorry to keep asking this, but it's the dreaded abreviations again. Please explain IMPO and S/P MI for the lay people amonst us. Thanks again for your insightful contributions to the group.0
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Thanks again Tsazani for the explanation. I also appreciate your sense of humour.0
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I’m late to the party on this topic because I just joined.
I was on statins for a number of years, and noticed that I was experiencing loss of memory (to the point that, in the middle of a sentence, had to stop because I forgot the word I wanted to say). My muscle tone and strength lessened (I could tighten my quad and almost push my finger to the bone), and it greatly interfered with my sleep ( I would sleep for one hour, be awake for 4 hours and would fall asleep for an hour almost wherever I was.) This was becoming a quality of life issue. After researching statins, I found that statins can cause all of these problems. I told my Dr. that I wanted off the statins and he suggested I change statins. I suggested I take a lipid panel and let that determine it. My total cholesterol was 154, down from 163, My HDL was 48, up from 38, my LDL was 86, up from 70, and my triglycerides was 101, down from 275. He took me off the statins. THAT NIGHT and most nights since, I have slept for 6 to 8 hours, my memory has returned (as much as a 67 year old's memory can) and my muscle tone and strength are improvi ng.
I accomplished this by making a sustainable lifestyle change: seldom, if ever, eating any industrial food (including all grains, manufactured sugar or oils), eliminating most dairy, eating local, in season, fruits and vegetables and lean meats.
I try to keep my carbs between 50 and 75 grams.
Edited to show grams of carbs so no one thinks it is %.0 -
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Unfortunately, I didn’t realize I was “intolerant” until several years later. The problems didn’t happen overnight.0
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Hi,
I am Type 2 and take: Metformin, Januvia, Lipitor, Diovan, baby aspirin, Levoxyl and a few others. My doc said that Diovan would protect my kidneys.
I have not been very good with keeping my BS/A1C low adn am worried that I m ay have to taker insulin at some point. I am hoping that with diet and exercise I can lose the weight and maybe decrease the diaberes meds or at least stave off insulin.
Question:s
1. Is it more difficult for insulin resistant/diabetic people to lose weight or is that a myth?
2. How many of you are very low carb and if so, how do you keep the carbs low?
Thanks!
mdp0 -
I was on Lipitor and got horrible side effects, and a nice side dose of a big jump in my A1c over the year and some months I was on it! As an experiment I stopped taking it and my glucose levels gradually returned to their prior levels. Sorry, but there seems to be a lot of curing the disease and killing the patient these days, and I'm convinced that the side effects of the Lipitor were far more detrimental to my body than the increased cholesterol. I take Metformin now (thanks to the Lipitor experience), ARB and baby aspirin. It's going to be a hard sell for my doctor to get me back on a statin again after my experience with it.....0
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1. Is it more difficult for insulin resistant/diabetic people to lose weight or is that a myth?
2. How many of you are very low carb and if so, how do you keep the carbs low?
Thanks!
mdp
My Dr. told me I would have a lot of trouble losing weight. Well, if he meant its not going to drop off, he was right. I lose anywhere from a half pound to 2 pounds a week. I expected that anyway. But I AM losing.
I keep my carbs at about 100g or less a day. I do it by eating more protein. I go over the max on occasion, but either not by much or on special occasions. But I manually lowered my carbs in my settings because of the diabetes. My fasting sugar is consistently under 100 so I am pleased.0 -
I’m late to the party on this topic because I just joined.
I was on statins for a number of years, and noticed that I was experiencing loss of memory (to the point that, in the middle of a sentence, had to stop because I forgot the word I wanted to say). My muscle tone and strength lessened (I could tighten my quad and almost push my finger to the bone), and it greatly interfered with my sleep ( I would sleep for one hour, be awake for 4 hours and would fall asleep for an hour almost wherever I was.) This was becoming a quality of life issue. After researching statins, I found that statins can cause all of these problems. I told my Dr. that I wanted off the statins and he suggested I change statins. I suggested I take a lipid panel and let that determine it. My total cholesterol was 154, down from 163, My HDL was 48, up from 38, my LDL was 86, up from 70, and my triglycerides was 101, down from 275. He took me off the statins. THAT NIGHT and most nights since, I have slept for 6 to 8 hours, my memory has returned (as much as a 67 year old's memory can) and my muscle tone and strength are improvi ng.
I accomplished this by making a sustainable lifestyle change: seldom, if ever, eating any industrial food (including all grains, manufactured sugar or oils), eliminating most dairy, eating local, in season, fruits and vegetables and lean meats.
I try to keep my carbs between 50 and 75 grams.
Edited to show grams of carbs so no one thinks it is %.
I experienced similar side effects on simvastatin. I didn't realize until way over a year that it was the medicine causing it. Once I got pancreatiitis, I researced it and refused to stay on it. My primary doctor, the one who prescribed it, was the ONLY one upset and disagreed with my decision. However, my endocrinologist, rheumatologist, gastroenterologist, and even cardiologist agreed with me. We have to be our own advocates. Incidentally, I was diagnoed with fibromyalgia during the time I was on simvastatin and miraculously was able to stop taking the meloxicam for it shortly after stopping the simvastin! I'm glad you're doing well without the medicine.0 -
Hi,
I am Type 2 and take: Metformin, Januvia, Lipitor, Diovan, baby aspirin, Levoxyl and a few others. My doc said that Diovan would protect my kidneys.
I have not been very good with keeping my BS/A1C low adn am worried that I m ay have to taker insulin at some point. I am hoping that with diet and exercise I can lose the weight and maybe decrease the diaberes meds or at least stave off insulin.
Question:s
1. Is it more difficult for insulin resistant/diabetic people to lose weight or is that a myth?
2. How many of you are very low carb and if so, how do you keep the carbs low?
Thanks!
mdp
It's definitely more difficult to lose weight but by no means impossible. We just need to adhere to a stricter diet. Simple carbs will forever be our enemy.
I have my carbs set to 50%, just around 200g. That's not considered low, rather moderate. I rarely go over. You really need to do some research - read food labels, etc. I've replaced white rice with barley, regular bread with Arnold deli flats, white potatoes with sweet potatoes. Small changes like this really make a big difference. I try to only have one or two a day combined. You also need to watch things such as pretzels. I use them as a treat with a tablespoon of nutella maybe once a week or every other week.
Reducing fat is also very important for diabetics. I count my saturated fats as opposed to total fat & it's been helping a lot. The "goood" fats are the monounsaturated fatty acids (MUFA) found in avocados, certain nuts, darl chocolate & olive oil. I make sure to have at least 3 servings a week but would like to do more. They actually help burn belly fat.
I've also cut my fruits to one a day and have it early in the day.
Feel free to send me an email if you're interested in more of my little tricks to lose weight.
Best of luck to you.0 -
Before dr. changed my meds I was pretty low carb. Muffin in a Minute was a lifesaver when I was craving bread. You can search for assorted recipes. It has very few carbs. I try to avoid too many white flour and potato products. I eat loads of non starchy veggies. I try to stick to whole grain carbs like WW bread, brown rice, and quinoa. My worse weakness is fruit and for months I only ate one or less pieces per day. I spent about 3 months around 25-30 net carbs per day. Then I upped it to 40-60 because I was losing steam and couldn't work out and focus on school. Even that was kind of tough for me.
I try to not eat any starch at least one meal a day, often dinner. I try to only eat 1 slice of bread at a time. I eat low carb tortillas, those are way lower in carbs and even the cals aren't bad. I look for other low carb subs like Sugar free syrup, jam etc.
I watch saturated fats but I use olive oil. My salad dressing is basalmic or other vinegar with about 1/2 teaspoon of olive oil. I sometimes use it to cook with, sometimes I use spray in the pan, depends on what all I'm eating.0 -
The change of having a heart attack is 4 times higher for diabetics. High LDL cholesterol is associated with a much higher increased rate of heart attack and lowering LDL with statins lowers the risk of heart attacks. (Now if you questions these facts, well do whatever you want to do, your body your health, your choices).
Current recommendation is to lower LDL to below 100 and 70 if you are diabetic.
I am taking Crestor, a statin, which lowers my LDL to 80 from 150, and have no side effects in the last 8 years.
Basically, the way I see it, there is a much higher real risk of a heart attack and potentially a small chance of side effects of medication. Easy choice the way I see it.
There is no question as to whether to take the meds to bring your numbers within the normal range. what I'm questioning is why to continue taking the meds if your labwork comes back fine and you're doing everything you should be doing to keep it that way, i.e. proper diet and exercise. I'm not trying to have an arguement. I'm simply playing devil's advocate and trying to understand the benefits of medicating your body if labwork indicates otherwise.
I agree my doctor was trying to put me on a statin for high triglycerides. My LDL and HDL were in good shape. She hadn't even controlled my diabetes and was trying to control something that is caused by diabetes. I started Lantus about a month ago and my BG is now in a normal range and my triglycerides went from over 400 to 145. Hmmmmm If you get the disease under control no need for more meds. Control the problem not the symptoms. My LDL droped from 76 to 56 I don't and never did have a cholesterol problem I have diabetes. The high numbers were a symptom of type 2.0 -
Hi,
I am Type 2 and take: Metformin, Januvia, Lipitor, Diovan, baby aspirin, Levoxyl and a few others. My doc said that Diovan would protect my kidneys.
I have not been very good with keeping my BS/A1C low adn am worried that I m ay have to taker insulin at some point. I am hoping that with diet and exercise I can lose the weight and maybe decrease the diaberes meds or at least stave off insulin.
Question:s
1. Is it more difficult for insulin resistant/diabetic people to lose weight or is that a myth?
2. How many of you are very low carb and if so, how do you keep the carbs low?
Thanks!
mdp
I understand you not wanting to take shots. Lord knows I didn't want to either. But I do like that my diabetes is under control now. Yes it is harder for people with insulin resistance to lose weight. I try and keep my carbs under 30 grams every two hours and always eat 17 or more grams of protein with every carb intake. It is called linking and balanceing. The Proteins help prolong the carb / glucose intake in to the blood. Keeps you at a more steady keel. I would love to talk to you more about insulin resistance.0 -
Question:s
2. How many of you are very low carb and if so, how do you keep the carbs low?
Thanks!
mdp
There is a group here on MFP called "Low Carber Daily Forum....The Group!!!" When I was lowering my carbs, I found that group helpful.0
