From: Dave on
Hi Everyone,

Was seeking advice on doctors recommendation to go on a low dose
cholesterol lowering medication.

Current numbers:

LDL 105
HDL 38 (should be above 40 according to lab)
Triglycerides 53

A am a Type II diabetic well controlled by diet (mostly) and exercise.
I am 35 years old. My Doctor recommends LDL below 70 for Diabetics. I
don't think my numbers are bad (and I do like my doctor),but I am
concerned about long term effects for what I consider fairly good
results.

I appreciate any opinions and advice.

Thanks!
From: Susan on
x-no-archive: yes

Dave wrote:
> Hi Everyone,
>
> Was seeking advice on doctors recommendation to go on a low dose
> cholesterol lowering medication.
>
> Current numbers:
>
> LDL 105
> HDL 38 (should be above 40 according to lab)
> Triglycerides 53
>
> A am a Type II diabetic well controlled by diet (mostly) and exercise.
> I am 35 years old. My Doctor recommends LDL below 70 for Diabetics. I
> don't think my numbers are bad (and I do like my doctor),but I am
> concerned about long term effects for what I consider fairly good
> results.
>
> I appreciate any opinions and advice.
>
> Thanks!

There is absolutely no evidence supporting benefits from these targets.
If you're DM controlling your lipids that well with diet and
excercise, you must know that your low TGLs mean you're doing a very
good job. TGL
has been found to be a more reliable indpendent predictor of CVD than
LDL has. Your lipid ratios are great, too. Your HDL not being above 40
isn't so important with so little LDL and TGL in your bloodstream.

Statins carry risks that your profile indicates you have no need to take.

Susan
From: David Rind on
Dave wrote:
> Hi Everyone,
>
> Was seeking advice on doctors recommendation to go on a low dose
> cholesterol lowering medication.
>
> Current numbers:
>
> LDL 105
> HDL 38 (should be above 40 according to lab)
> Triglycerides 53
>
> A am a Type II diabetic well controlled by diet (mostly) and exercise.
> I am 35 years old. My Doctor recommends LDL below 70 for Diabetics. I
> don't think my numbers are bad (and I do like my doctor),but I am
> concerned about long term effects for what I consider fairly good
> results.
>
> I appreciate any opinions and advice.
>
> Thanks!

There's not a simple answer to this. Many people have misinterpreted the
goal LDL levels from the proposed revised NCEP guidelines to suggest
that all diabetics should have an LDL below 70. This isn't what the
revised guidelines say.

Independing of that, though, statins reduce cardiac risks in everyone,
and this has been particularly well proven in diabetics. The Heart
Protection Study showed the same relative benefit with statin therapy in
diabetics with LDL's that were quite low as were seen in diabetics with
much higher LDL's. Statins reduce cardiac risks by 25-30% in pretty much
everyone who takes them.

However, the absolute benefit is smaller with a lower starting LDL,
because the absolute cardiac risk isn't as great. In someone who is
young and has a low LDL and has not had diabetes for a long time, the
reduced risk with a statin might not be worth the risk of side effects
to some patients. On the other hand, starting a statin early might cause
some cumulative cardiac protection over time, and also decrease the risk
of the other vascular complications of diabetes.

Personally, I don't think the concept of a goal LDL is really relevant
at all in a situation like this. I do think a lot of doctors would at
least recommend that a type II diabetic with the lipid profile above
take a statin once they had diabetes for 5-10 years.

--
David Rind
drind(a)caregroup.harvard.edu
From: Andrew B. Chung, MD/PhD on
Dave wrote:
> Hi Everyone,
>
> Was seeking advice on doctors recommendation to go on a low dose
> cholesterol lowering medication.
>
> Current numbers:
>
> LDL 105

Bit higher than optimal

> HDL 38 (should be above 40 according to lab)

Not optimal.

Will come up as you lose the visceral adipose tissue (VAT).

> Triglycerides 53

Optimal.

> A am a Type II diabetic well controlled by diet (mostly) and exercise.
> I am 35 years old. My Doctor recommends LDL below 70 for Diabetics.

Many do.

> I
> don't think my numbers are bad (and I do like my doctor),but I am
> concerned about long term effects for what I consider fairly good
> results.

Would suggest you discuss your concerns with your doctor.

S/he has your best interest at heart for recommending an LDL less than
70 mg/dL being that you are diabetic.

If you choose to lose the VAT by eating less, it is likely that you
will be able to lower your LDL to less than 70 mg/dL without
cholesterol lowering medications.

Understanding with your heart the following two articles should help
you achieve this:

http://HeartMDPhD.com/HolySpirit/overweight.asp

http://MabletonGA.OurLittle.net/DreadNought

> I appreciate any opinions and advice.
>
> Thanks!

You are welcome.

All thanks and praises belong to GOD, Whom I love with all my heart,
soul, mind, and strength.

May HE continue to heal your heart by curing your diabetes, dear
neighbor Dave whom I love unconditionally.

Prayerfully in Christ's amazing love,

Andrew <><
--
Andrew B. Chung
Cardiologist, Atlanta, Georgia, USA
http://HeartMDPhD.com/HolySpirit

As for knowing who are the very elect, these you will know by the
unconditional love they have for everyone including their enemies
(Matthew 5:44-45, 1 Corinthians 13:3, James 2:14-17).
http://HeartMDPhD.com/Love

From: capmack on
Suggest you ignore any advice from a. chung. He has a non-scientific
agenda which drives his responses, he is ill informed about the most up
to date literature and he ignores treatments which all diabetics should
be following because they do not meet with the goals of his agenda and
lack of knowledge in this area. Bottom line, he can safely be ignored
with complete ease of mind because the truth is not in his responses.