Replies to This Discussion

Permalink Reply by Super_sally on May 16, 2012 at 8:00pm

Hi,

Are you sure your numbers are correct? LDL of 55 and HDL of 128?
HDL is good cholesterol. The higher it is the better.
Also important is the ratio between HDL and LDL.

I think you are right to be concerned about taking a statin. Just being diabetic is not a good reason to take one.

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Permalink Reply by Super_sally on May 16, 2012 at 8:02pm

What is your A1C now? You might no longer meet diagnosis criteria for diabetes. Even more reason not to take a statin (I am biased, can you tell?).

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Permalink Reply by Sam on May 16, 2012 at 8:03pm

Hey there,

I'm not a doctor, and I sure don't know all of your particulars that your doctor hopefully does-- but based alone on what you said here, I think I would recommend getting a second opinion right away. If you A1C was 5.7 at initial diagnosis, I'm not sure why you were diagnosed. A1C of 6.5 or greater is considered diagnostic criteria for diabetes of any type (by the labs I go to at least). If you rarely have a BG over 115 without any meds, I am not sure what the problem is... Also if they told you are a type one diabetic with or without the "LADA" term, but didn't put you on some sort of insulin regimen immediately-- hopefully they gave you a pretty thorough explanation why not.

Also I don't understand what you listed as your cholesterol numbers, did you accidentally misplace the numbers?-- do you mean that your LDL is 128? and HDL is 55? And your doctor wanted your LDL below 100? If so, that is very similar to what my lipids were at the time of diagnosis-- which was a big surprise to me, because they were totally normal a year before when I had routine blood work done. They did put me on a small (10mg) dose of atoravastatin (lipitor) due to my elevated LDL and triglycerides at my initial diagnosis. I'm hoping I won't have to be on it for very long, as I think my numbers were just messed up because I was pretty sick-- with A1c over 11 at the time.

Keep us posted,
Sam

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Permalink Reply by Sam on May 16, 2012 at 8:26pm

Hey there again, I just read the rest of your profile. I saw that you were diagnosed as type 1, or LADA with a natural serum insulin level of 11? That sets off some alarm bells in my mind also--- 11 is well within the normal range-- actually perfectly between what would be considered the high normal and low normal levels based on my own lab reports. Did they do a C-peptide test? That is an essential test for determining a diagnosis of type 1 or LADA. Again I'm far from an expert, and this is all new to me too, but it really sounds to me like you might benefit from a second opinion...

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Permalink Reply by Lab Mouse on May 16, 2012 at 9:22pm

Well I was in a hurry to get to a dinner and mixed up HDL and LDL. So to get it straight, bad cholesterol 128. Dx was confirmed with a GAD antibody factor greater than 250 I pegged the meter, and a fasting bg of 130. Anyway my low carb diet has kept my numbers low. I have experimented by eating a known number of cabs and found I go up 1 point for every gram of carb and will come back below 100 within 3 hours

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Permalink Reply by Tim on May 19, 2012 at 5:36am

If you A1C was 5.7 at initial diagnosis, I'm not sure why you were diagnosed. A1C of 6.5 or greater is considered diagnostic criteria for diabetes of any type (by the labs I go to at least)

I know the type of lab paperwork you are talking about. Every time I get an A1C in the high 5's, the lab paperwork comes back with the explanation column saying that this means I am at "moderate risk for diabetes". I kinda chuckle at that!

That's one of many possible diagnostic criteria. An A1C of 5.7 is definitely abnormally high for a young healthy adult that doesn't have diabetes. I wasn't diagnosed with an A1C, I was diagnosed by showing up as a kid in the ER in DKA and turning the Tes-Tape jet black when they dipped it in my urine.

About 1991 when I was looking for a new Endo, I went to one that had been highly highly recommended by the docs at my school's clinic. He ran an A1C on me and told me that I didn't have diabetes at all. (Despite the fact that I had been insulin dependent for nearly 10 years and had pretty dang good control.) Needless to say, my opinion of that endo wasn't as high as everyone elses.

Today a LADA who is diagnosed early on and maintains tight control, might never ever have an A1C over 6.5. Ever.

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Permalink Reply by Super_sally on May 17, 2012 at 12:20am

Ok. So you are LADA and in the honeymoon stage. Sounds like you are doing super with your diet and exercise and weight loss. HOpe you can continue this long term.

Your HDL is good and your LDL is not terribly high. High fat diets don't cause high cholesterol as long as they are not high carb as well.

You can read up Dr. Richard Bernstein (Diabetes Solutions) on this if you are interested.

In your shoes I personally would resist the statin and just keep doing what you're already doing.

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Permalink Reply by Brian (bsc) on May 17, 2012 at 5:15am

Unfortunately, many doctors believe diabetes is actually caused by high cholesterol and that the primary treatment should be a statin. This is crazy.

There is no compelling evidence that cholesterol lowering or statin use is of any benefit as a secondary treatment (i.e. if you don't have CVD). The guidelines for diabetics were made more aggresive "just because" they have more CVD. But, duh, the CVD is driven by high blood sugars?

If you read around, most people find that with a high HDL and low Tris, any LDL is often the big "fluffy" kind which is actually good. Treatment with statins to correct a non-problem is a bad thing. Unfortunately, since there are guidelines telling doctors to medicate all diabetics, doctors are not liable for problems caused by prescribing statins and they just overdo it. I personally refuse to take statins no matter what my labs say. I tell my doctors to not bother testing because I am going to refuse to do anything and it is just wasting money. But they demand to do it anyway and waste money.

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Permalink Reply by Jonah on May 18, 2012 at 4:17pm

As you are not currently at risk of diabetic heart disease (no high blood sugar) and as statins have many nasty side effects, and as your cholesterol is in a good range for a nondiabetic, and as furthermore your current cholesterol levels may still be being influenced by earlier high blood sugars, I advise you to not take statins.

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Permalink Reply by Lab Mouse on May 18, 2012 at 5:50pm

Thanks for all the replies. I called the doctor today to get some more numbers. Mu total cholesterol is 194 and my triglycerides were 137 last September and now the tri's are 57..I don't thinkI will have the prescription filled...

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Permalink Reply by Sam on May 18, 2012 at 9:43pm

Good call man. You post inspired me to review my own labs. At my initial time of diagnosis my lipids were similar to yours, except my triglycerides were much higher (over 200). Like I said this was really a surprise-- as I had just gotten full blood work done for a life insurance policy about a year ago and everything was perfectly fine then. I do think all my lipids were out of whack just due to the super high glucose I had been living with for some time when diagnosed. I plan to ask my doctor for some new tests to determine if the statins are actually a good idea anymore now that my glucose levels have stabilized. I really do think the labs you've cited invite some questions about your diagnosis, and I hope that your doctor explained them all adequately to you.

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Permalink Reply by Tim on May 19, 2012 at 5:45am

As you are not currently at risk of diabetic heart disease (no high blood sugar)

I don't think it's that simple.

Just me looking at the DCCT results... an A1C in the high 5's does not eliminate the risks of microvascular complications, the ones that are highly correlated with high average bg's. It just puts you at a lower risk than an A1C in the 6's, or an A1C in the 7's, or an A1C in the 8's. I don't see any magic average bg below which the risk completely disappears.

And looking at the follow-on DCCT results for heart disease as they've come available (now over 25 year timespan in the study and follow-ons), they find that (compared to the nondiabetic population) even the DCCT participants with A1C's in the 5's (a tiny bin but still there in the statistics) have a risk for heart disease that's greatly elevated compared to the non-diabetic population. Yes, good bg control helps, because the risk for a diabetic with an A1C in the 5's is less than with an A1C in the 9's or 10's. But it's still greatly elevated compared to the non-diabetic population.

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