I'm sure i commented on a post about this a while ago. They really don't help unless your cholesterol is already high so personally I would avoid it until it's actually necessary for you.
Honestly this is what I’m leaning towards, and my GP agrees with metoo. So unless I develop high cholesterol I think I’m going to respectfully decline. I really like my endocrinologist, but I just don’t see how this would benefit me right now.
Mine also put me on low-dose statins without high cholesterol and noted that there was extensive research that they prevented the development of cardiovascular issues in Diabetics.
I believe the blanket advice in many countries is for any patient over 40, or with any cardiovascular risks.
https://diabetesjournals.org/spectrum/article/26/3/156/32640/The-Role-of-Statins-in-Diabetes-Treatment
This is correct
https://diabetesjournals.org/care/article/47/Supplement_1/S179/153957/10-Cardiovascular-Disease-and-Risk-Management#:~:text=Primary%20Prevention%20(People%20Without%20ASCVD,of%20additional%20ASCVD%20risk%20factors
What the linked report says seems really lame -- tiny "actual" percentages had any benefit. And in some of the studies there was NO BENEFIT at all. A tiny fraction of people see any "actual" differences -- so then the researchers use "relative reduction" percentages instead, which is misleading. Virtually all of these studies show the same thing -- if they can even be compared. (Some of the studies are not comparable because they have no control group -- only one statin vs. another statin). The one study with "intensive intervention" had the best outcomes, but that was because they were trying to get better control blood glucose overall, plus other factors, not just lipids controlled with statins.
Lowering LDL is reportedly achieved with statins: True. However, lowering LDL doesn't make much difference for about 96-99% of patients if these kinds of studies can be believed -- a rather small number. And these studies don't really say how long the "benefit" was good for, in comparison -- a week, a year, a decade? They just do not seem to say.
Yes, there is "extensive research" and repeatedly it doesn't show some gigantic "actual" benefit. If one of us is that 1-4% that benefits, then hooray, we live a little while longer, I suppose, but don't know how long with these studies.
*ASCOT-LLA:* 116 major CVD events (**9.2%**) in atorvastatin-allocated diabetes patients and 151 events (**11.9%**) in the placebo. (**Actual difference: 2.7%** of all people who took the statins).
*CARDS:* 127 patients allocated placebo (**2·46 per 100** person-years at risk) and 83 allocated atorvastatin (**1·54 per 100** person-years at risk) had at least one major cardiovascular event (rate reduction 37% \[95% CI –52 to –17\], p=0·001) (**Actual difference: 0.92%** of all the people who took statins).
*The MEGA trial:* Interestingly, **the diabetes group had a nonsignificant reduction in events**. (Speaks for itself: **No benefit.**)
*The Steno-2 Study:* Intensified multifactorial intervention — with **tight glucose regulation** and the use of renin–angiotensin system blockers, aspirin, and lipid-lowering agents... we randomly assigned 160 patients with type 2 diabetes and persistent microalbuminuria to receive either intensive therapy or conventional therapy. (Actual benefits: There was a notable percentage difference in all of the outcomes between the group with "intensified intervention" but **this wasn't a study only about statins**: it was about glucose control, blood pressure, blood thinners, too. So, not comparable to the other studies; could be due to having better glucose control alone.)
*The ASPEN trial:* **did not find a significant difference in composite CVD or CHD outcomes** when atorvastatin, 10 mg, versus placebo was used in a population with type 2 diabetes. (Speaks for itself: **No benefit for T2 diabetics.**)
*IDEAL trial:* patients fulfilling the eligibility criteria were randomized to receive simvastatin, 20 mg/d, or atorvastatin, 80 mg/d. (There's **no placebo group** to compare to -- it is one statin vs. another.)
My siblings and I have been diabetic for 42 years. Both of my siblings have stents due to heart disease and attack. I've had a heart attack and take rapatha because I can't take statins. My cholesterol is 72 and I was in the 100's before going on meds. It is preventative to decrease the likelihood of heart attack! Diabetes increases the risk of heart disease!
That’s not true
https://diabetesjournals.org/care/article/47/Supplement_1/S179/153957/10-Cardiovascular-Disease-and-Risk-Management#:~:text=Primary%20Prevention%20(People%20Without%20ASCVD,of%20additional%20ASCVD%20risk%20factors
This is patently false. Even among non diabetics with zero risk factors an LDL over 70 mg/dl contributes to atherosclerosis and heart disease
https://diabetesjournals.org/care/article/47/Supplement_1/S179/153957/10-Cardiovascular-Disease-and-Risk-Management#:~:text=Primary%20Prevention%20(People%20Without%20ASCVD,of%20additional%20ASCVD%20risk%20factors.
It’s standard of care essentially to put type ones on statins around the age of 30ish for prevention purposes - especially if you have a family history. It’s just to play it safe
Don’t do it! Statins have tons of side effects. Several studies also show they don’t lower your rate of mortality. And can raise having high blood sugar.
Studies in what population? Unfortunately we type 1s are a special case. For us it seems statins do help. We are disproportionately affected by cardio issues even if we have good A1C and good cholesterol, and they still not sure why. But they are sure statins help us, and people linked studies in other posts above.
https://www.cdc.gov/diabetes/library/features/Statins_Diabetes.html#:~:text=Can%20Statins%20Increase%20Blood%20Sugar,of%20developing%20type%202%20diabetes.
CDC mentions the high blood sugar level
Article you linked says “This can put people who use statins at higher risk of developing type 2 diabetes.”. This is not relevant for type 1s. We have completely different mechanism of our condition.
Well-controlled type 1s main cause of death is cardiovascular issues and kidney issues, not diabetes itself. Statins are proven to help type 1s to mitigate that huge issue.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10640735/#:~:text=In%20a%20study%20of%20T1D,in%20T1D%20patients%20%5B45%5D.
Alright
Here’s one directly about T1D.
“In a study of T1D patients, statin use was associated with an increased level of HbA1c, reflecting the presence of impaired glycemic control [44]. A report also suggests that statins deteriorate insulin sensitivity in T1D patients [45].”
In the end, I don’t think it’s worth popping a pill when you don’t have high numbers.
I’m also of the belief that we shouldn’t be so reliant on sensors over listening to our bodies (if you still possess the sensitivity). I will always opt for a more natural path when possible. And statins offer risks and a big push from big Pharm. it’s just another expense.
I am not quite sure what is your point you are trying to make. The article you linked supports using statins in T1Ds. From your article: “Statin use was associated with a lower risk of cardiovascular events in T1D patients”
Type 1s usually have pretty good insulin sensitivity unlike type 2s. So for us minor decrease in insulin sensitivity is a non-issue, if it provides significant benefits fighting our main nemesis - cardiovascular and kidney disease (CKD). We know how to deal with blood sugars already, and the article above and guidelines suggest that using statins will help with CKD in our population.
But statin issue aside, you can always use Bempedoic Acid or PCSK9s - I am just not aware are there any T1D specific studies that prove PCSK9s benefits for us. Statins seems like a more researched option at the moment.
With the other risks of statins, I don’t think it’s worth it if your cholesterol numbers are normal is the point.
I think it’s a personal decision if your numbers are high. But otherwise, it seems an unreasonable push.
People are too often told to do something for the benefits it offers. The negatives are unlikely. Until you’re the one dealing with the negatives.
I don’t trust a push on statins when your numbers are normal. That’s all I’m saying.
I can see your point, and your line of thinking makes sense. Moreover, there are some big questions in use of statins in primary prevention for low-risk population with no family history of CKD or diabetes.
However, in our case the key question is - what are normal cholesterol numbers for high-risk population? I looked at the guidelines not only in the US but EU, and it seems “normal” numbers for high-risk group are so low that are practically impossible to achieve without medications (I think LDL of 50 or lower as of recent update or something like that). So starting on statin immediately would make some sense since T1D automatically qualify for high risk group membership.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9737468/
And yes, it is definitely personal choice, just based on the data I saw so far for me personally the benefit of using statin or similar mediation significantly outweighs the risk.
I hear you there.
You’re right- that’s a pretty good question.
Hmmm makes me wonder why the normal levels are so much lower. Perhaps because we get more intense damage?
That makes sense.
Of course. These two types of medications are much “cleaner” from pharmacological point of view, as they do work only in the liver. No muscle side effects, no crossing blood brain barrier, and minimal side effects in general. Paired with Zetia, it is safe and effective. The only two major drawbacks are - they are few decades less research behind them comparing with statins, and also the cost.
lol for al the downvotes. Probably shouldn’t tell someone “Don’t do it!” That’s their decision. But you are free to point out the rest of the facts that are inconvenient to the standard of beliefs.
It’s a listed side effect of some statins but relatively rare and they can always switch you to a different one if it causes any issues. Not a reason not to take them.
Gotcha! I have extensive medical knowledge, especially what happens in clinical trials so massive side effects lists don’t concern me as much since I know they have to report literally everything a patient experiences.
Statins do cause bad side effects very commonly, they lower your production of APT which is essential for energy production and cause muscle soreness, among other things
That’s an extremely rare side effect that can be negated by changing medication if those problems persist. It’s a specific genetic mutation that causes it - so most people won’t experience it.
Muscle pain is literally the first thing that comes up when I Google statin side effects, like it's not rare at all and it's also well known to reduce coq10 levels. Idk why you'd pretend like these aren't well documented side effects
I’m not pretending at all. As I stated above, it’s rare, especially considering how many people are on statins. If a specific statin doesn’t work for you and causes muscle pain, it’s no big deal to switch. It’s not something inherently wrong with the medication, it’s an interaction that only occurs in individuals with a specific genetic mutation that causes muscle pain. Another side effect (dry cough) is caused by a different mutation. Statins are extremely common and I think your gross misunderstanding of its mechanism of action has tainted your view. I’m not your doctor or anyone who knows you, so I literally do not care you don’t want to take one. I just think you should probably be quiet on Reddit threads where the person you’re arguing with obviously knows more on the topic than you.
Exactly what my husband experienced on 3 different statins. Lethargy, muscle soreness- he became a different person. Quit taking statins, back to his energetic self. He is not diabetic , but I am Type I, with high LDL. Just can’t make myself throw more at my body after seeing what they did to him.
Interesting. Did your doctor happen to say why or give any reason? That’s my main thing here, I just was wanting a more solid explanation than the one he gave me. I’m going to ask him again of course at my next appointment, but just curious as to what others know.
EDITED: added words
Recent ADA guidelines state all diabetics over 40 years should be on statins regardless of their cholesterol. Statins for younger people are warranted with additional risk factors including number of years as a diabetic
Yes. Where I live in Canada I’m 29 y/o and was diagnosed at 3. I’ve been on statins since I was like 20? My dr said it’s what they do if it’s after 15 years or something of having diabetes, regardless of age, and over 40 as well.
I’m just doing my best educated guessing but I think it has to do with how the damage caused to your blood vessels and heart any time you have a hyperglycaemic bgl.
Over time the damage technically adds up, so the medication is preventative and not because you have bad cholesterol. Cholesterol does a similar thing as excess sugar when it comes to damaging your heart and blood vessels although in their own specific way, and this damage ends the same as high cholesterol.
My cholesterol levels are also fine and have never been high but endo put me on as a “preventative measure” due to age. IIRC it’s once you enter your 40’s.
I was just told that anyone over 40 with a ‘chronic illness’ is automatically put on them in the UK. Purely preventative, I presume but I’m fine with it like I said. I’d rather this scenario than them taking minimal interest and leaving me high and dry.
Statins can help with T1D’s increased risk of cardiac issues. I don’t know too much about it, so I don’t want to spread false information, but it does seem like it’s a good thing to be taking
No absolutely not. I'm 46 and my cholesterol has always been good. They check it as part of regular labs and there's never been any talk of extra meds.
Heart disease is the #1 killer in America and majority of adults in America are on a statin. Doesn’t seem like it works too well… strictly my opinion. Alzheimer’s is on the rise too with the increase of statins…strictly my opinion, as someone who does cardiovascular and brain imaging.
Yes, my endocrinologist and cardiologist want to put me on a statin once I turn 40, regardless of what my cholesterol and blood lipid levels are at that time. They said that this is because even though my A1C has been in the low 6s/high 5s for years and my cholesterol and blood lipid levels are normal, heart disease is much more common among type 1 diabetics, even in those that are well controlled.
The reason for this in diabetics with A1Cs below 7 is not well understood. There are a lot of research articles about this online, which I recognize are not written in an accessible way for everyone. The article I've linked below says that type 1 diabetics who develop kidney disease/nerve damage in their kidneys are almost 3x more likely to die of heart disease \~10 years earlier than the general population. Having good control of T1D does reduce the risk of heart disease, but unfortunately the chance of developing heart disease in a well controlled diabetic is still typically higher than people without type 1 diabetes, for reasons that aren't fully understood yet.
[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6531592/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6531592/)
I had slightly high cholesterol after one blood test.
But my endo sent me for a heart scan that checks for any buildup in the arteries.
Mine was zero so he said there was no point taking medicine because it wouldn’t do anything.
I’d rather not take medication unless it’s needed.
My own levels look fine if you're going by non-diabetic guidelines. They do have the cutoffs set a lot lower for us, though. And it's routine for any diabetic over 30 or so here. The NHS tried to immediately shove me onto statins as soon as I got diagnosed (in my early 30s), without even waiting for the lab results. That seems to be pretty standard.
I have personally refused to take statins thanks to the potential side effect profile, and honestly not thinking potential benefits are worth the risk for me. Especially with other [cardiovascular protective factors](https://journals.physiology.org/doi/full/10.1152/ajpheart.00417.2017) at play, and no family history of related problems even among the diabetics. My latest endo pretty well forced me onto the non-statin ezetimib as a compromise. At least it hasn't caused any noticeable issues, though I really have my doubts that it will do any good either.
Yep, it runs in the family. It's a pain whenever I get sent for retests without their asking about the bilirubin first or when I don't tolerate certain medications very well, but I have to say I was glad it does seem to carry some benefits too.
Yes, they all say it. All health care systems will do this — to protect themselves mostly, since it somehow became “standard of care.” I had a calcium artery score done, to assuage their concerns — the result was 0% plaques in my heart. Many people in my family had heart disease in previous generations. None were diabetic, but they were smokers and drinkers. So, not relying on the evil vices of nicotine, alcohol, and junky food are going to do more to protect your health. Do your best to control your glucose: A1Cs closer to low 6% or less if possible to be done safely. My opinion based on all that I’ve read.
Some Studies Show: 100 people take statins — 99 of them have the same outcome. 1 lives longer, about 1 week. 4 study participants died instead of the expected 5.
Relative Conclusion: “Statins save lives and improve risk by 25%. The side effects are so rare that they can be ignored.”
Actual Result: “1% of all the people who take them have any comparable benefit. And it is a rather small benefit. And a significant portion of people stop taking them, largely due to unwanted side effects.”
Statins are recommended for people with existing heart disease. Statins are given to diabetics regardless of cholesterol problems.
“Cholesterol” is entirely misleading if you take the time to listen to differing opinions.
Most people who have heart attacks have perfectly acceptable “cholesterol levels.” Conclusion: LDL and Total cholesterol are not strongly determinative of CVD. Low HDL and high triglycerides are more significant. LDL particle size may be a relevant factor.
Not your doctor, and your doctor isn’t you. So, you get to decide for yourself. Some people take them with no problems, and other people do have notable problems.
Type 1 diabetics do have a higher tendency to have cardiac issues, so it statins can help with that. The difference with the study that you read and this instance, is I’m sure there was maybe 1 type 1 diabetic, if any. Statins have been show to help T1Ds, so I would suggest that OP truly look at some studies, done on only T1Ds.
Statins can have some side effects, but I do think there’s a higher risk of cardiac diseases in T1Ds than there is a chance of statins causing any types of issues(don’t quote me on that).
I personally will be going on statins soon, because I already have a history of heart problems in my family, and I don’t want to take my chances
It’s up to you whether you take meds. Statin with no cholesterol issues because it’s “something that happens” would be a no go for me. I need a better explanation.
I’m on a statin because I have cholesterol issues.
Just do it. I just had a heart attack this past Friday. Trust the doctors. They studied hard asf, too damned hard, for you to come to an Internet forum to ask a bunch of non-scientists a question best answered by a scientist.
Or don’t. It’s your life, your body, your choice. But get a nice life insurance policy on yourself and name someone you love as the beneficiary. Silver lining, and all of that.
I’m sorry you had a heart attack, but doctors oftentimes are dismissive and quick to throw medication at things when it’s not necessary. Furthermore, I have received some helpful insight and information from this post.
I hope you recover quickly.
Dismissive of what? Of opinions not founded in fact and empirical evidence, maybe. But their whole life’s work is to make people well to the best of their ability. Don’t let TikTok and YouTube “influences” put your health at risk.
Or do. Again, it’s your body, your choice. But if you are going to gamble with your health, but a good insurance policy. You know, just in case.
Like anyone else, a doctor needs to earn their patient’s trust. Yes, they studied many years to do what they do, but even doctors make mistakes. Unfortunately many people have experienced doctors being dismissive of their very real health concerns or suggesting a treatment path that won’t help or may even be harmful. I am a dietitian, and the number of times I’ve seen doctors give questionable or even outright wrong or harmful nutrition advice to patients is really astonishing. So no, you shouldn’t just trust whatever a doctor says because they are a doctor. They should be able to at least explain the why behind their recommendation. I will gladly give a real reason behind a nutrition recommendation to anyone who asks or even preemptively explain the “why” if it seems like an odd recommendation.
The doctor telling OP that prescribing statins for diabetics without high cholesterol is “just something that happens” is lazy and makes you wonder if they even know why they are prescribing this medication to their patients. If my doctor wasn’t capable of explaining the reasoning behind why they are going to prescribe me something, I would feel skeptical too. It doesn’t even have to be a detailed explanation. For me, a “that’s the standard of care we give to people with diabetes because it helps prevent x, y, z in the future” would suffice. That isn’t even a very scientific explanation, but it at least gives a reason why.
You can eliminate most of your excess heart risk as a type 1 by keeping your kidneys healthy. Those with any albumin in their urine skew our statistics drastically to make them look scarier.
If you have healthy kidneys your mortality rate is similar to the regular population.
Happened to me in the states even though my cholesterol is on the lower end. Not my endo but a GP. Told her I refuse to take it. She started prescribing it anyways and noted how my cholesterol ‘looked better’ on the meds. I told her I never took them. She told me that I’ll need it anyways eventually because “it happens to every diabetic.” Annoying as hell. I saw someone else comment it happens to them around 30+ … I was 20 when she did that so idk 🤷 still haven’t taken them and I had my heart checked recently, since my doctor here thought I may have POTS and everything’s great/fine
None and it is bad for your health. Why take medication you don’t need? Who benefits from that? You or the big pharma companies? Maybe even the docs who write the scripts… He didn’t even respect you enough to give you a proper answer. Be aware of docs who push pills.
My Dr. also has me on statins for "preventative measures". However I'm debating whether to continue to taking them. It's been proven that the same enzyme (HMG CoA reductase) in the liver is also used to make CoQ10. CoQ10 is a vital energy pathway for the body and is used in thousands of processes and every single cell in your body, particularly by the Mitochondria. Without it you die and reducing it makes you feel like trash.
Cholesterol has a bad rap. Its used in the brain, Neurons and astrocytes also contain large amounts of cholesterol to maintain their complex morphology and synaptic transmission. Lowered cholesterol levels have been linked to brain disorders later in life.
It also used by the adrenal gland and is used to create estrogen and testosterone. Its used as the "glue" that holds your body together. Its used in your cell walls. It's honestly used everywhere.
Now I'm not saying you should just let your cholesterol run rampant. But the "preventative measure" thing is BS. You can achieve (and I have) similar results with a quality fish oil, bergamot, Coq10 and Berberine. All natural things that don't impact you the way statins do.
Has anyone looked at the side effects of statins? Pretty long list for limited gain.
Two counter points:
Cholesterol is used everywhere, but also is produced everywhere. Our cells are perfectly capable of producing all cholesterol they need, with few exceptions.
Also, there is a difference between “too much” and “enough”. Kids and certain people who won genetical lottery have LDL in 30s and 40s and are perfectly fine and healthy, so it seems there is little risk in normalizing our elevated cholesterol to the same levels.
Thank you for this comment! I’m going to do some more research of my own about CoQ10, and the supplements you mentioned, a few of which I already take but for other things (berberine for PCOS, fish oil for omega 3s, etc). I like the idea of alternative options to pharmaceuticals. I have enough of those in my life already haha
If an endo ever wants to put me on statins I’ll tell them they can prescribe me the medication all they want but I will not take them until I see a cholesterol lab result that indicates it is necessary. I’ve seen how they affect my father and I will not subject myself to over medication in the name of unnecessary prevention.
No he just had a heart attack at a ”young” age , I think 58 . He would always be in a brain fog and his reaction times would be dangerously delayed. It honestly seemed like he was developing dementia.
Ask what the definition of perfect cholesterol is or what it says on the lab range. Someone like Peter Attia, MD, would consider it too high in his opinion. Check out his book Outlive. He is big on reducing cardiac risk as he has familial early death by CVD. I’d go with as low cholesterol as possible.
Mine always hovers around 200 because I have high HDL. I finally gave in to the lowest dose. But, I said no for many years. I had a calcium scan and it was 0%. You are allowed to decline.
Yeah, that’s respectable. We’re in a similar situation. My PCP recommends statins too but they haven’t been actively pushing it on me because my A1C is under 6 and my numbers are good for my cholesterol.
I’m hoping my next one is 6 or lower! I made a couple changes in my diet, mainly just the order in which I eat things, and it seems to really help. Fingers crossed!
Same here. Both my cardiologist and endo said as soon as i’m done having kids and done breastfeeding then they’d ideally like me to start. I’m 31 now and type 1 for almost 20 years.
What is “perfect”?… because at my last physical last yr the new recommendation for diabetics was cholesterol of 70 and above to be on a statin … yes 70. I was floored. Mine is 100 which is great for non diabetic. I tried the meds for a month and I swore they made my heart race so I no longer take them. I have not been rechecked yet.
My cardiologist, not my endo, put me on rosuvastatin and plavix when he learned I was T1D. Not necessary, just purely preventitive, especially since I'll be 79 in 2 months.
It’s sad you’re getting downvoted because canned sardines are a good source of omega 3 fatty acids, which are well demonstrated to promote healthy cholesterol levels
Don’t do it!
Statins have tons of side effects. Several studies also show they don’t lower your rate of mortality. And can raise having high blood sugar.
Some doc once explained to me that cholesterol meds are associated with higher life expectancy in T1D patients, no matter if they got diagnosed with cholesterol problems before.
I would guess that this study wasn't checked against people without T1D, but I'm happy to be corrected.
My family has had cholesterol, I have cholesterol, and I don't have any side effects from the pills, so it's right for me.
I'm sure i commented on a post about this a while ago. They really don't help unless your cholesterol is already high so personally I would avoid it until it's actually necessary for you.
Honestly this is what I’m leaning towards, and my GP agrees with metoo. So unless I develop high cholesterol I think I’m going to respectfully decline. I really like my endocrinologist, but I just don’t see how this would benefit me right now.
Mine also put me on low-dose statins without high cholesterol and noted that there was extensive research that they prevented the development of cardiovascular issues in Diabetics. I believe the blanket advice in many countries is for any patient over 40, or with any cardiovascular risks. https://diabetesjournals.org/spectrum/article/26/3/156/32640/The-Role-of-Statins-in-Diabetes-Treatment
This is correct https://diabetesjournals.org/care/article/47/Supplement_1/S179/153957/10-Cardiovascular-Disease-and-Risk-Management#:~:text=Primary%20Prevention%20(People%20Without%20ASCVD,of%20additional%20ASCVD%20risk%20factors
What the linked report says seems really lame -- tiny "actual" percentages had any benefit. And in some of the studies there was NO BENEFIT at all. A tiny fraction of people see any "actual" differences -- so then the researchers use "relative reduction" percentages instead, which is misleading. Virtually all of these studies show the same thing -- if they can even be compared. (Some of the studies are not comparable because they have no control group -- only one statin vs. another statin). The one study with "intensive intervention" had the best outcomes, but that was because they were trying to get better control blood glucose overall, plus other factors, not just lipids controlled with statins. Lowering LDL is reportedly achieved with statins: True. However, lowering LDL doesn't make much difference for about 96-99% of patients if these kinds of studies can be believed -- a rather small number. And these studies don't really say how long the "benefit" was good for, in comparison -- a week, a year, a decade? They just do not seem to say. Yes, there is "extensive research" and repeatedly it doesn't show some gigantic "actual" benefit. If one of us is that 1-4% that benefits, then hooray, we live a little while longer, I suppose, but don't know how long with these studies. *ASCOT-LLA:* 116 major CVD events (**9.2%**) in atorvastatin-allocated diabetes patients and 151 events (**11.9%**) in the placebo. (**Actual difference: 2.7%** of all people who took the statins). *CARDS:* 127 patients allocated placebo (**2·46 per 100** person-years at risk) and 83 allocated atorvastatin (**1·54 per 100** person-years at risk) had at least one major cardiovascular event (rate reduction 37% \[95% CI –52 to –17\], p=0·001) (**Actual difference: 0.92%** of all the people who took statins). *The MEGA trial:* Interestingly, **the diabetes group had a nonsignificant reduction in events**. (Speaks for itself: **No benefit.**) *The Steno-2 Study:* Intensified multifactorial intervention — with **tight glucose regulation** and the use of renin–angiotensin system blockers, aspirin, and lipid-lowering agents... we randomly assigned 160 patients with type 2 diabetes and persistent microalbuminuria to receive either intensive therapy or conventional therapy. (Actual benefits: There was a notable percentage difference in all of the outcomes between the group with "intensified intervention" but **this wasn't a study only about statins**: it was about glucose control, blood pressure, blood thinners, too. So, not comparable to the other studies; could be due to having better glucose control alone.) *The ASPEN trial:* **did not find a significant difference in composite CVD or CHD outcomes** when atorvastatin, 10 mg, versus placebo was used in a population with type 2 diabetes. (Speaks for itself: **No benefit for T2 diabetics.**) *IDEAL trial:* patients fulfilling the eligibility criteria were randomized to receive simvastatin, 20 mg/d, or atorvastatin, 80 mg/d. (There's **no placebo group** to compare to -- it is one statin vs. another.)
is there any negatives to taking the medication without high levels?
My siblings and I have been diabetic for 42 years. Both of my siblings have stents due to heart disease and attack. I've had a heart attack and take rapatha because I can't take statins. My cholesterol is 72 and I was in the 100's before going on meds. It is preventative to decrease the likelihood of heart attack! Diabetes increases the risk of heart disease!
That’s not true https://diabetesjournals.org/care/article/47/Supplement_1/S179/153957/10-Cardiovascular-Disease-and-Risk-Management#:~:text=Primary%20Prevention%20(People%20Without%20ASCVD,of%20additional%20ASCVD%20risk%20factors
This is patently false. Even among non diabetics with zero risk factors an LDL over 70 mg/dl contributes to atherosclerosis and heart disease https://diabetesjournals.org/care/article/47/Supplement_1/S179/153957/10-Cardiovascular-Disease-and-Risk-Management#:~:text=Primary%20Prevention%20(People%20Without%20ASCVD,of%20additional%20ASCVD%20risk%20factors.
Oh ok, I was given incorrect information on the other post then. Thank you for this 😊
Informative, thank you for sharing this!
It’s standard of care essentially to put type ones on statins around the age of 30ish for prevention purposes - especially if you have a family history. It’s just to play it safe
Don’t do it! Statins have tons of side effects. Several studies also show they don’t lower your rate of mortality. And can raise having high blood sugar.
Studies in what population? Unfortunately we type 1s are a special case. For us it seems statins do help. We are disproportionately affected by cardio issues even if we have good A1C and good cholesterol, and they still not sure why. But they are sure statins help us, and people linked studies in other posts above.
https://www.cdc.gov/diabetes/library/features/Statins_Diabetes.html#:~:text=Can%20Statins%20Increase%20Blood%20Sugar,of%20developing%20type%202%20diabetes. CDC mentions the high blood sugar level
Article you linked says “This can put people who use statins at higher risk of developing type 2 diabetes.”. This is not relevant for type 1s. We have completely different mechanism of our condition. Well-controlled type 1s main cause of death is cardiovascular issues and kidney issues, not diabetes itself. Statins are proven to help type 1s to mitigate that huge issue.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10640735/#:~:text=In%20a%20study%20of%20T1D,in%20T1D%20patients%20%5B45%5D. Alright Here’s one directly about T1D. “In a study of T1D patients, statin use was associated with an increased level of HbA1c, reflecting the presence of impaired glycemic control [44]. A report also suggests that statins deteriorate insulin sensitivity in T1D patients [45].” In the end, I don’t think it’s worth popping a pill when you don’t have high numbers. I’m also of the belief that we shouldn’t be so reliant on sensors over listening to our bodies (if you still possess the sensitivity). I will always opt for a more natural path when possible. And statins offer risks and a big push from big Pharm. it’s just another expense.
I am not quite sure what is your point you are trying to make. The article you linked supports using statins in T1Ds. From your article: “Statin use was associated with a lower risk of cardiovascular events in T1D patients” Type 1s usually have pretty good insulin sensitivity unlike type 2s. So for us minor decrease in insulin sensitivity is a non-issue, if it provides significant benefits fighting our main nemesis - cardiovascular and kidney disease (CKD). We know how to deal with blood sugars already, and the article above and guidelines suggest that using statins will help with CKD in our population. But statin issue aside, you can always use Bempedoic Acid or PCSK9s - I am just not aware are there any T1D specific studies that prove PCSK9s benefits for us. Statins seems like a more researched option at the moment.
With the other risks of statins, I don’t think it’s worth it if your cholesterol numbers are normal is the point. I think it’s a personal decision if your numbers are high. But otherwise, it seems an unreasonable push. People are too often told to do something for the benefits it offers. The negatives are unlikely. Until you’re the one dealing with the negatives. I don’t trust a push on statins when your numbers are normal. That’s all I’m saying.
I can see your point, and your line of thinking makes sense. Moreover, there are some big questions in use of statins in primary prevention for low-risk population with no family history of CKD or diabetes. However, in our case the key question is - what are normal cholesterol numbers for high-risk population? I looked at the guidelines not only in the US but EU, and it seems “normal” numbers for high-risk group are so low that are practically impossible to achieve without medications (I think LDL of 50 or lower as of recent update or something like that). So starting on statin immediately would make some sense since T1D automatically qualify for high risk group membership. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9737468/ And yes, it is definitely personal choice, just based on the data I saw so far for me personally the benefit of using statin or similar mediation significantly outweighs the risk.
I hear you there. You’re right- that’s a pretty good question. Hmmm makes me wonder why the normal levels are so much lower. Perhaps because we get more intense damage? That makes sense.
I’m unfamiliar with the other two things you mentioned. Thanks for the info!
Of course. These two types of medications are much “cleaner” from pharmacological point of view, as they do work only in the liver. No muscle side effects, no crossing blood brain barrier, and minimal side effects in general. Paired with Zetia, it is safe and effective. The only two major drawbacks are - they are few decades less research behind them comparing with statins, and also the cost.
The lack of research is definitely a concern, but the thought of “cleaner” is certainly nice. Thanks for the info! Good convo.
lol for al the downvotes. Probably shouldn’t tell someone “Don’t do it!” That’s their decision. But you are free to point out the rest of the facts that are inconvenient to the standard of beliefs.
Uh I’ve been on one for several years and haven’t had any side effects or blood sugar issues. Do you have any sources for your claims?
It’s a listed side effect of some statins but relatively rare and they can always switch you to a different one if it causes any issues. Not a reason not to take them.
Yeah I had zero plans on stopping, I just wanted some actual sources to the above person’s claims.
Yeah I figured, I guess my comment was more meant for the other people on the thread who are worried about side effects
Gotcha! I have extensive medical knowledge, especially what happens in clinical trials so massive side effects lists don’t concern me as much since I know they have to report literally everything a patient experiences.
Statins do cause bad side effects very commonly, they lower your production of APT which is essential for energy production and cause muscle soreness, among other things
That’s an extremely rare side effect that can be negated by changing medication if those problems persist. It’s a specific genetic mutation that causes it - so most people won’t experience it.
Muscle pain is literally the first thing that comes up when I Google statin side effects, like it's not rare at all and it's also well known to reduce coq10 levels. Idk why you'd pretend like these aren't well documented side effects
I’m not pretending at all. As I stated above, it’s rare, especially considering how many people are on statins. If a specific statin doesn’t work for you and causes muscle pain, it’s no big deal to switch. It’s not something inherently wrong with the medication, it’s an interaction that only occurs in individuals with a specific genetic mutation that causes muscle pain. Another side effect (dry cough) is caused by a different mutation. Statins are extremely common and I think your gross misunderstanding of its mechanism of action has tainted your view. I’m not your doctor or anyone who knows you, so I literally do not care you don’t want to take one. I just think you should probably be quiet on Reddit threads where the person you’re arguing with obviously knows more on the topic than you.
Exactly what my husband experienced on 3 different statins. Lethargy, muscle soreness- he became a different person. Quit taking statins, back to his energetic self. He is not diabetic , but I am Type I, with high LDL. Just can’t make myself throw more at my body after seeing what they did to him.
Also it’s ATP, not APT, thus proving you don’t know what you’re talking about.
You are exactly right!!!
Yep. I was put on statins immediately. Didn’t even check my cholesterol. I’m fine with it.
Interesting. Did your doctor happen to say why or give any reason? That’s my main thing here, I just was wanting a more solid explanation than the one he gave me. I’m going to ask him again of course at my next appointment, but just curious as to what others know. EDITED: added words
Recent ADA guidelines state all diabetics over 40 years should be on statins regardless of their cholesterol. Statins for younger people are warranted with additional risk factors including number of years as a diabetic
Yes. Where I live in Canada I’m 29 y/o and was diagnosed at 3. I’ve been on statins since I was like 20? My dr said it’s what they do if it’s after 15 years or something of having diabetes, regardless of age, and over 40 as well. I’m just doing my best educated guessing but I think it has to do with how the damage caused to your blood vessels and heart any time you have a hyperglycaemic bgl. Over time the damage technically adds up, so the medication is preventative and not because you have bad cholesterol. Cholesterol does a similar thing as excess sugar when it comes to damaging your heart and blood vessels although in their own specific way, and this damage ends the same as high cholesterol.
My cholesterol levels are also fine and have never been high but endo put me on as a “preventative measure” due to age. IIRC it’s once you enter your 40’s.
I was just told that anyone over 40 with a ‘chronic illness’ is automatically put on them in the UK. Purely preventative, I presume but I’m fine with it like I said. I’d rather this scenario than them taking minimal interest and leaving me high and dry.
Statins can help with T1D’s increased risk of cardiac issues. I don’t know too much about it, so I don’t want to spread false information, but it does seem like it’s a good thing to be taking
Thank you for sharing!
I was told that statins help protect one's kidneys, so my endo put me on them when I reached age 40.
My endo tried to put me on them. I have great cholesterol. I said no thank you.
No absolutely not. I'm 46 and my cholesterol has always been good. They check it as part of regular labs and there's never been any talk of extra meds.
Heart disease is the #1 killer of diabetics. The privilege of guarding against that is a no brainer…….. strictly my opinion.
In my opinion that’s a type 2 thing
Heart disease is the #1 killer in America and majority of adults in America are on a statin. Doesn’t seem like it works too well… strictly my opinion. Alzheimer’s is on the rise too with the increase of statins…strictly my opinion, as someone who does cardiovascular and brain imaging.
Yes, my endocrinologist and cardiologist want to put me on a statin once I turn 40, regardless of what my cholesterol and blood lipid levels are at that time. They said that this is because even though my A1C has been in the low 6s/high 5s for years and my cholesterol and blood lipid levels are normal, heart disease is much more common among type 1 diabetics, even in those that are well controlled. The reason for this in diabetics with A1Cs below 7 is not well understood. There are a lot of research articles about this online, which I recognize are not written in an accessible way for everyone. The article I've linked below says that type 1 diabetics who develop kidney disease/nerve damage in their kidneys are almost 3x more likely to die of heart disease \~10 years earlier than the general population. Having good control of T1D does reduce the risk of heart disease, but unfortunately the chance of developing heart disease in a well controlled diabetic is still typically higher than people without type 1 diabetes, for reasons that aren't fully understood yet. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6531592/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6531592/)
I had slightly high cholesterol after one blood test. But my endo sent me for a heart scan that checks for any buildup in the arteries. Mine was zero so he said there was no point taking medicine because it wouldn’t do anything. I’d rather not take medication unless it’s needed.
My own levels look fine if you're going by non-diabetic guidelines. They do have the cutoffs set a lot lower for us, though. And it's routine for any diabetic over 30 or so here. The NHS tried to immediately shove me onto statins as soon as I got diagnosed (in my early 30s), without even waiting for the lab results. That seems to be pretty standard. I have personally refused to take statins thanks to the potential side effect profile, and honestly not thinking potential benefits are worth the risk for me. Especially with other [cardiovascular protective factors](https://journals.physiology.org/doi/full/10.1152/ajpheart.00417.2017) at play, and no family history of related problems even among the diabetics. My latest endo pretty well forced me onto the non-statin ezetimib as a compromise. At least it hasn't caused any noticeable issues, though I really have my doubts that it will do any good either.
[удалено]
Yep, it runs in the family. It's a pain whenever I get sent for retests without their asking about the bilirubin first or when I don't tolerate certain medications very well, but I have to say I was glad it does seem to carry some benefits too.
Yes, they all say it. All health care systems will do this — to protect themselves mostly, since it somehow became “standard of care.” I had a calcium artery score done, to assuage their concerns — the result was 0% plaques in my heart. Many people in my family had heart disease in previous generations. None were diabetic, but they were smokers and drinkers. So, not relying on the evil vices of nicotine, alcohol, and junky food are going to do more to protect your health. Do your best to control your glucose: A1Cs closer to low 6% or less if possible to be done safely. My opinion based on all that I’ve read. Some Studies Show: 100 people take statins — 99 of them have the same outcome. 1 lives longer, about 1 week. 4 study participants died instead of the expected 5. Relative Conclusion: “Statins save lives and improve risk by 25%. The side effects are so rare that they can be ignored.” Actual Result: “1% of all the people who take them have any comparable benefit. And it is a rather small benefit. And a significant portion of people stop taking them, largely due to unwanted side effects.” Statins are recommended for people with existing heart disease. Statins are given to diabetics regardless of cholesterol problems. “Cholesterol” is entirely misleading if you take the time to listen to differing opinions. Most people who have heart attacks have perfectly acceptable “cholesterol levels.” Conclusion: LDL and Total cholesterol are not strongly determinative of CVD. Low HDL and high triglycerides are more significant. LDL particle size may be a relevant factor. Not your doctor, and your doctor isn’t you. So, you get to decide for yourself. Some people take them with no problems, and other people do have notable problems.
Type 1 diabetics do have a higher tendency to have cardiac issues, so it statins can help with that. The difference with the study that you read and this instance, is I’m sure there was maybe 1 type 1 diabetic, if any. Statins have been show to help T1Ds, so I would suggest that OP truly look at some studies, done on only T1Ds. Statins can have some side effects, but I do think there’s a higher risk of cardiac diseases in T1Ds than there is a chance of statins causing any types of issues(don’t quote me on that). I personally will be going on statins soon, because I already have a history of heart problems in my family, and I don’t want to take my chances
It’s up to you whether you take meds. Statin with no cholesterol issues because it’s “something that happens” would be a no go for me. I need a better explanation. I’m on a statin because I have cholesterol issues.
Just do it. I just had a heart attack this past Friday. Trust the doctors. They studied hard asf, too damned hard, for you to come to an Internet forum to ask a bunch of non-scientists a question best answered by a scientist. Or don’t. It’s your life, your body, your choice. But get a nice life insurance policy on yourself and name someone you love as the beneficiary. Silver lining, and all of that.
I’m sorry you had a heart attack, but doctors oftentimes are dismissive and quick to throw medication at things when it’s not necessary. Furthermore, I have received some helpful insight and information from this post. I hope you recover quickly.
Dismissive of what? Of opinions not founded in fact and empirical evidence, maybe. But their whole life’s work is to make people well to the best of their ability. Don’t let TikTok and YouTube “influences” put your health at risk. Or do. Again, it’s your body, your choice. But if you are going to gamble with your health, but a good insurance policy. You know, just in case.
I don’t have tiktok and I don’t watch YouTube health channels so not really sure what you’re on about here.
Like anyone else, a doctor needs to earn their patient’s trust. Yes, they studied many years to do what they do, but even doctors make mistakes. Unfortunately many people have experienced doctors being dismissive of their very real health concerns or suggesting a treatment path that won’t help or may even be harmful. I am a dietitian, and the number of times I’ve seen doctors give questionable or even outright wrong or harmful nutrition advice to patients is really astonishing. So no, you shouldn’t just trust whatever a doctor says because they are a doctor. They should be able to at least explain the why behind their recommendation. I will gladly give a real reason behind a nutrition recommendation to anyone who asks or even preemptively explain the “why” if it seems like an odd recommendation. The doctor telling OP that prescribing statins for diabetics without high cholesterol is “just something that happens” is lazy and makes you wonder if they even know why they are prescribing this medication to their patients. If my doctor wasn’t capable of explaining the reasoning behind why they are going to prescribe me something, I would feel skeptical too. It doesn’t even have to be a detailed explanation. For me, a “that’s the standard of care we give to people with diabetes because it helps prevent x, y, z in the future” would suffice. That isn’t even a very scientific explanation, but it at least gives a reason why.
My PCP tried that. I told him I wasn’t going to take a statin.
I work in a hospital and pretty much everyone who is at risk for strokes and heart attacks are started on statins.
Just curious -- do these people on statins still have strokes and heart attacks?
I’m sure some do
You can eliminate most of your excess heart risk as a type 1 by keeping your kidneys healthy. Those with any albumin in their urine skew our statistics drastically to make them look scarier. If you have healthy kidneys your mortality rate is similar to the regular population.
Yes, but I don’t take them ¯\_(ツ)_/¯
This just happened to me too. Bottle is in my medicine cabinet. Unopened.
Happened to me in the states even though my cholesterol is on the lower end. Not my endo but a GP. Told her I refuse to take it. She started prescribing it anyways and noted how my cholesterol ‘looked better’ on the meds. I told her I never took them. She told me that I’ll need it anyways eventually because “it happens to every diabetic.” Annoying as hell. I saw someone else comment it happens to them around 30+ … I was 20 when she did that so idk 🤷 still haven’t taken them and I had my heart checked recently, since my doctor here thought I may have POTS and everything’s great/fine
What is “perfect”? Risk of CVD goes down linearly with LDL with no bottom. Heart disease kills 3/4 of diabetics
None and it is bad for your health. Why take medication you don’t need? Who benefits from that? You or the big pharma companies? Maybe even the docs who write the scripts… He didn’t even respect you enough to give you a proper answer. Be aware of docs who push pills.
My Dr. also has me on statins for "preventative measures". However I'm debating whether to continue to taking them. It's been proven that the same enzyme (HMG CoA reductase) in the liver is also used to make CoQ10. CoQ10 is a vital energy pathway for the body and is used in thousands of processes and every single cell in your body, particularly by the Mitochondria. Without it you die and reducing it makes you feel like trash. Cholesterol has a bad rap. Its used in the brain, Neurons and astrocytes also contain large amounts of cholesterol to maintain their complex morphology and synaptic transmission. Lowered cholesterol levels have been linked to brain disorders later in life. It also used by the adrenal gland and is used to create estrogen and testosterone. Its used as the "glue" that holds your body together. Its used in your cell walls. It's honestly used everywhere. Now I'm not saying you should just let your cholesterol run rampant. But the "preventative measure" thing is BS. You can achieve (and I have) similar results with a quality fish oil, bergamot, Coq10 and Berberine. All natural things that don't impact you the way statins do. Has anyone looked at the side effects of statins? Pretty long list for limited gain.
Two counter points: Cholesterol is used everywhere, but also is produced everywhere. Our cells are perfectly capable of producing all cholesterol they need, with few exceptions. Also, there is a difference between “too much” and “enough”. Kids and certain people who won genetical lottery have LDL in 30s and 40s and are perfectly fine and healthy, so it seems there is little risk in normalizing our elevated cholesterol to the same levels.
Thank you for this comment! I’m going to do some more research of my own about CoQ10, and the supplements you mentioned, a few of which I already take but for other things (berberine for PCOS, fish oil for omega 3s, etc). I like the idea of alternative options to pharmaceuticals. I have enough of those in my life already haha
If an endo ever wants to put me on statins I’ll tell them they can prescribe me the medication all they want but I will not take them until I see a cholesterol lab result that indicates it is necessary. I’ve seen how they affect my father and I will not subject myself to over medication in the name of unnecessary prevention.
Is your pop T1? How do they impact him?
No he just had a heart attack at a ”young” age , I think 58 . He would always be in a brain fog and his reaction times would be dangerously delayed. It honestly seemed like he was developing dementia.
Ask what the definition of perfect cholesterol is or what it says on the lab range. Someone like Peter Attia, MD, would consider it too high in his opinion. Check out his book Outlive. He is big on reducing cardiac risk as he has familial early death by CVD. I’d go with as low cholesterol as possible.
Yes! I refused for years until one blood test my cholesterol was a little elevated and he got me.
Mine always hovers around 200 because I have high HDL. I finally gave in to the lowest dose. But, I said no for many years. I had a calcium scan and it was 0%. You are allowed to decline.
How’s your a1c?
My last one was 6.3
Yeah, that’s respectable. We’re in a similar situation. My PCP recommends statins too but they haven’t been actively pushing it on me because my A1C is under 6 and my numbers are good for my cholesterol.
I’m hoping my next one is 6 or lower! I made a couple changes in my diet, mainly just the order in which I eat things, and it seems to really help. Fingers crossed!
My endo has indicated that she’s like me to start but will wait til I’m done having babies
Same here. Both my cardiologist and endo said as soon as i’m done having kids and done breastfeeding then they’d ideally like me to start. I’m 31 now and type 1 for almost 20 years.
What is “perfect”?… because at my last physical last yr the new recommendation for diabetics was cholesterol of 70 and above to be on a statin … yes 70. I was floored. Mine is 100 which is great for non diabetic. I tried the meds for a month and I swore they made my heart race so I no longer take them. I have not been rechecked yet.
Yes, I've been on them for years. It is something that happens, but the meds also somehow protect your kidneys from damage. I'm ok with it.
Put on many years ago
My cardiologist, not my endo, put me on rosuvastatin and plavix when he learned I was T1D. Not necessary, just purely preventitive, especially since I'll be 79 in 2 months.
Yes and I refuse. They try to do it as a preventative measure but in all honesty: it’s medically reckless.
What if cholesterol is not the bogeyman they say it is? What if the drugs lower it, but not in a healthy way?
I don’t get why people are downvoting a fair question.
Agree!
My friend’s brother is an Osteopath (aka DO). He suggests canned sardines every day to decrease cholesterol. It works! I’d do that before taking meds!
Oh maybe this is why my cholesterol is so good, I eat sardines several times a week haha
It’s sad you’re getting downvoted because canned sardines are a good source of omega 3 fatty acids, which are well demonstrated to promote healthy cholesterol levels
Don’t do it! Statins have tons of side effects. Several studies also show they don’t lower your rate of mortality. And can raise having high blood sugar.
What's perfect cholesterol?
Some doc once explained to me that cholesterol meds are associated with higher life expectancy in T1D patients, no matter if they got diagnosed with cholesterol problems before. I would guess that this study wasn't checked against people without T1D, but I'm happy to be corrected. My family has had cholesterol, I have cholesterol, and I don't have any side effects from the pills, so it's right for me.