Thanks for offering your opinion. Before I begin, I want to say I respect your choices. My intent is not to put any one down, but to express my thoughts and defend my position on the matter.
The main issue I and others have with this NY Times article is that it is all about cholesterol and is pretty much an infomercial for statins. They are essentially saying that all diabetics should be on statins, which I vehemently disagree with. According to my research, the heart disease risk in diabetics is much more complex than cholesterol. In fact, I beleive messed up cholesterol is more a symptom than a cause. I think the medical establishment is fixated on cholesterol to the point it ignores other and probably more significant factors in heart disease.
Dr. Mary Vernon has been successful treating diabetes with a low carb diet. Her response to the article points out that cholesterol abnormalities often result from problems in glucose metabolism. If you fix the root cause -- correct the glucose metabolism, the cholesterol will take care of itself. I have seen this happen in my own experience. Focusing on cholesterol is just a band-aid approach.
http://rjr10036.typepad.com/askdrvernon/2007/08/gk.htmlJenny, a low carb blogger with diabetes points out other factors in diabetes-related heart disease.
http://diabetesupdate.blogspot.com/2007/08...ort-misses.htmlEven the NY Times article notes that diabetics have more small, dense LDL particles, which are the dangerous ones. The larger LDL particles are harmless. High blood sugar also raises triglycerides, hardens arteries, and inhibits the body from clearing cholesterol from the blood. Elevated insulin levels as a result of insulin resistance cause plaque buildup in the arteries. Statins don't help any of these conditions. There is a correlation between blood sugar levels and heart disease risk. Even "pre-diabetic" levels double the risk of heart disease. Yet the medical establishment is overjoyed with levels in the "pre-diabetic" and even "diabetic ranges." An A1C of 6% represents a 28% greater risk for heart disease than an A1C of 5%. Yet the medical establishemnt is overjoyed with an A1C of 6% or even 7%.
http://www.diabetesincontrol.com/results.p...oryarticle=5055Furthermore, statins don't work by lowering cholesterol, but through anti-inflamatory and other effects. Even then, they only provide a trivial benefit in reducing heart attacks or major cardiovascular events. The drug companies use relative risk to make things sound better than they really are. If you look at absolute risk reduction, it's not that impressive. In one study, CARDS, where diabetics were given 10 mg atorvastatin (Lipitor):
127 adverse events in the placebo group of 1410 = 9% adverse events
83 adverse events in the treament group of 1428 = 5.8% adverse events
So, I have a 9% chance of heart attack if I don't take atorvastatin vs. a 5.8 % chance if I do. The absolute risk reduction of 4.2% is less impressive than the stated 37% relative risk and not enough to entice me to take the drugs.
Furthermore, I came across another study, ASCOTT-LLA, where the results were 11.9% in the placebo group experienced adverse events vs. 9.2 in the atorvastatin treatment group. The 22% relative risk reduction is not as impressive as the 37% reduction in CARDS, but the absolute risk reduction of 2.7 is even less impressive. Then there was the ASPEN study which had to conclude that "Composite end point reductions were not statistically significant."
The CARDS study was stopped early because of the "great results," but it makes me wonder if statins are less effective with time. I don't see a significant benefit to taking statins. To me, the trivial risk reduction is not worth the potential side effects, some of which the medical establishment doesn't want to acknowledge. Two great sites for statin side effects are:
http://www.spacedoc.net/http://medicine.ucsd.edu/ses/Finally, I go back to the Dr. Mike Eads posts I mentioned earlier. One deals directly with the issue of statins for diabetics. Another discusses an article in The Lancet stating that lower cholesterol targets are NOT based on evidence. Looking at the studies, they found that statins provide no benefit in preventing heart attacks in women or the elderly. The only group that benefits from statins is middle aged men with existing cardiovascular disease (including diabetics who are at higher risk). Even then, you would have to treat about 65 people for five years with statins to prevent one heart attack. With odds like those, I'll take my chances without statins.
http://www.proteinpower.com/drmike/?p=678http://www.proteinpower.com/drmike/?p=510I tried to follow the medical establishment's dietary recommendations of low fat/hight carb. I just got fatter and fatter and ended up diabetic with high cholesterol & high blood pressure. Now that I have abandoned their recomendations and adopted a lifestyle they call "unhealthy," I'm getting better. When I stopped eating cereal for breakfast and started eating eggs (whole eggs, that is), my cholesterol went down and has stayed down -- and without drugs.
Please understand that I have a great distrust of the medical establishment in both cholesterol and blood sugar targets. The medical establishment is more concerned with getting LDL cholesterol under 100 mg/dl than with getting blood sugar under 100. They have it all bassackwards. Stop treating symptoms with band aids. Focus on the root cause of insulin resistance & impared glucose tolerance and the cholesterol & blood pressur will take care of itself. Yet, there is too much $$$ in cholesterol, both in drugs and processed foods claiming to lower cholesterol. Many of the folks on the panel that sets cholesterol targets have financial ties to the drug companies. Lower the cholesterol targets and increase revenues. It's all a big racket IMHO.
