Cholestrol

I am a type 1 diabetic and during my course my hba1c told me my cholesteol was too high at 6.33. They was not concerned about it and 5 months later without trying i have lowered it to 5.3. My gp has given me simvastatin (40mg) to take to lower it and told me i need to be on them for the rest of my life and did not give me a chance to lower it myself, is this right?

Welcome Jade_ellen.
Please note I am not an HCP.
But to my knowledge Statins are commonly given to type 1 diabetics. I think it likely that the majority of us here on the forum are prescribed them.
My cholestrol has always been in range in my 34 years as a type 1, but I was given them some 10 years ago when a 5 year American based research programme demonstrated their long term benefits for us.
Currently I take 10 mg Atorvastatin per day and my cholesterol is 3.9...so I'm happy to keep taking them.
There are underlying benefits, which my consultant talked about at the time.
I've copied this for you from the web for you and cut it down a bit to get to the salient points but you can read the whole article at: www/netdoctor.co.uk/diabetes/treatments/statins_and_diabetes_001904.htm

Statins and diabetes
Reviewed by Professor Ian Campbell, consultant physician

While a healthy lifestyle plays a part, the most effective way to reduce cholesterol levels is by using a group of medicines known as statins.
The treatment of diabetes has traditionally focused on controlling the blood sugar level through diet combined with injections of insulin or tablets.

There's no doubt that good glucose control is central to minimising the risk of long-term complications such as damage to nerves, circulation, kidneys and eyes.

But over recent years, attention has focussed on the fact that people with diabetes are up to four times more likely to suffer a major event involving the circulation – for example a heart attack or a stroke (cerebrovascular accident).

In fact, coronary heart disease is the leading cause of death in people who have both type 1 and type 2 diabetes.

All this means it's now recognised that diabetes, particularly type 2, is as much a disease of the circulatory system as it is of blood glucose control.
This leads to:
angina (chest pains)
heart attacks
stroke
poor circulation.
There have been significant inroads in the prevention and treatment of cardiovascular disease.

Stopping smoking and good blood pressure control has a significant impact in reducing long-term damage to the circulation.
Raised cholesterol levels is another factor that increases your cardiovascular risk.
The benefits from stopping smoking, reducing cholesterol levels and lowering high blood pressure multiply up.
Stopping smoking is probably the most important thing you can do to reduce your cardiovascular risk. Many GPs run special smoking cessation clinics. Diet and exercise help lower raised blood pressure. But how can you reduce cholesterol levels?

While a healthy lifestyle plays a part, the most effective way to reduce cholesterol levels is by using a group of medicines known as statins.

How do statins work?
Although we get cholesterol from our diet, more than 80 per cent of cholesterol in our bodies is made by the liver.

Statins slow the action of an enzyme in the liver that plays a key role in the manufacture of cholesterol. This causes the level of blood cholesterol to drop.

There are currently five medicines in this class available for prescription in the UK:

atorvastatin (Lipitor)
fluvastatin (Lescol), (Lescol XL)
pravastatin (Lipostat)
rosuvastatin (Crestor)
simvastatin (Zocor).
All of the statin medicines work in the same way.

How effective are statins for people with diabetes?
Statins lower cholesterol, but would they make a difference for people with diabetes? Two major studies investigated the benefits.

In both, the effects of a daily dose of a statin versus no treatment was compared in people with diabetes.

Collaborative Atorvastatin Diabetes Study (CARDS)
This study involved nearly 3000 people with type 2 diabetes aged 40-75.

It looked at the benefits of taking a 10mg dose of atorvastatin daily.

None of the participants had heart disease at the start of the trial, but they did have an extra risk factor for developing it, such as smoking, high blood pressure, diabetic retinopathy or protein in the urine indicating diabetic kidney disease.

For those taking the statin, the risk of heart attack reduced by 37 per cent and stroke by 48 per cent.

These benefits were seen regardless of age, sex or whether the cholesterol level was high or low.

The trial's success meant it was halted two years early.

The Heart Protection Study (HPS)
The HPS study involved nearly 6000 people with diabetes aged 40-80.

It looked at the benefits of taking a 40mg dose of simvastatin each day. Just under half of the participants showed signs of cardiovascular disease, while half did not.

It found this routine use of statins cut the number of heart attacks and strokes in both groups by a third.

Cholesterol levels
Ideal level: less than 4mmol/l.
Benefits were also seen in people whose cholesterol levels were not high in the first place (less than 5mmol/l) and in those at the top of the age range.

The results showed statins can prevent cardiovascular disease, because they reduced heart attacks and stroke in people who didn't have cardiovascular disease at the start of the trial.

What are the side effects?
Statins are generally well tolerated.

But in some people they cause headaches, affect liver function and cause stomach problems such as abdominal pain, constipation, flatulence, diarrhoea and vomiting.

More rarely, they can cause rashes and disorder of the muscles (myopathy).

Where a statin cannot be tolerated, alternative medications such as ezetimibe or a fibrate drug may be tried but these medications do not lower cholesterol to the same degree as a statin.

Should everyone with diabetes take a statin?
Statins should be considered for all people with diabetes over the age of 40, according to the NICE guidelines in 2008. Statins may be prescribed in diabetic patients who are under 40 years of age if there are additional cardiovascular risk factors, or if there is diabetic eye disease (retinopathy) or kidney disease (neuropathy) present.

The CARDS and HPS studies have clearly shown that statins reduce cardiovascular risk, regardless of how low cholesterol levels are in the first place.

This suggests there shouldn't be a level of blood cholesterol below which statin treatment is considered unbeneficial.

More research is now in progress to try and clarify the broader use of statins in diabetes treatment.

Read more: http://www.netdoctor.co.uk/diabetes/treatments/statins_and_diabetes_001904.htm#ixzz2pncXyfEK
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So do your best to reduce it yourself but as your liver is the main producer affecting your cholesterol level it is best controlled by pharmaceutical intervention.
Regards
Garry

I found that really useful.......

I was told when you hit 40 in the UK you get put on a statin for life, didn't really mind to be honest as I am on BP meds now anyway, but its good to hear the science behind it.....

Hi Jade-Ellen...well done on reducing cholesterol. I have got mine from 18!!!! to 5.6 through diet and insulin (they think the high levels were due to undiagnosed rare diabetes). As I am of child bearing age (and planning to have a family) they wont put me on statins to reduce it further, similar issue with Triglycerides (39 down to 3.1) which is still high but again wont give me treatment.
I hope you are not in the same boat (planning a family) as the statins are detrimental to a foetus!

Vicky
x

Thanks so much for replying and giving me that information it is very useful to me and now i understand a bit more as my gp did not really explain anything to me just told me i am on them for the rest of my life and thats it. I was just worried as i am only 21 years old and thought i was way too young to go on them but for some reason in the last 5 months my ldl has risen from a perfect 1.3 to 3.2 which is why they put me on them. And i was expecting the gp to say they would give me some time to lower it myself but i did not get that chance and yes I am hoping to start my own family with my boyfriend. I read that the statins are not to be taken when you are trying or pregnant

As my levels were so high I was referred to a lipids consultant, and it was him that said no statins etc until I decide my family is complete, regardless of how long that may be!! I was with the consultant for a year before he discharged me and now my diabetes consultant monitors it..he agrees no statins so they happy for me to tick along with slightly higher levels as I have brought them down probably as far as I can on diet only.
I would go back to your GP and explain about thinking of starting family and the risk of statin use...remember GPs won't know all the information, hence the need for specialists!