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RE: [IPk] Test Results



Allie,

http://www.diabetes.org.uk/infocentre/inform/statins.htm says the following 
regarding cholesterol levels: 'Ideally total cholesterol levels should be 
below 4mmol/L. Total cholesterol includes HDL and LDL cholesterol. 
Considered individually, then HDL cholesterol should be 1.0mmol/L or above 
for men, 1.2mmol/L or above for women, and LDL cholesterol should be below 
2.0mmol/L. Your fasting triglyceride should ideally be below 1.7mmol/L.'

Before agreeing to take a statin based on the total cholesterol number, ask 
your GP to work out your ratios of HDL to LDL. Statins are powerful drugs 
and doctors seem (to my mind) to be downplaying their effects on other body 
systems. Statins can worsen neuropathy in people with diabetes. If you have 
neuropathy, be sure your GP knows this if he does determine that you should 
take a statin. Recently one of our e-mail list members had to get his statin 
prescription changed after he developed painful neuropathic symptoms from 
the first one that he was prescribed. His cholesterol is genuinely high 
without medication so he really needs to take something, just certainly not 
the first drug that the doctor prescribed.

As your HDL ("good cholesterol") is quite high and your triglycerides are 
fine and you didn't say what your LDL is I can't anticipate precisely what 
your GP might have to say. Often statin prescriptions are based on the LDL 
being higher than the HDL. If your LDL is low, your triglycerides are low 
(as they are), and your HDL is high (as it is), I recommend you be a little 
pig-headed about the prospect of taking a statin. Ask your GP to run through 
with you the side effects of the drug and any research regarding that statin 
that was performed on subjects with a lipid profile like yours. If there is 
no published research on the effects of that drug on patients with a similar 
lipid profile to yours, then there is no clinical evidence that the drug 
will help you. Evidence-based medicine is what most doctors say they are 
practising these days so feel free to ask for evidence. (At least that is my 
philosophy.)

Also, you might want to share this information with your consultant and your 
GP:
http://www.nih.gov/news/pr/jun2005/niddk-12a.htm

Regarding the creatinine level: greater than 3.5 is the high-risk, 
get-worried score for albumin:creatinine execretion ratio (which I think may 
be the type of test that you had), according to 
http://www.staff.ncl.ac.uk/philip.home/ar1998.html (yes, it's a type 2 page, 
but I can't find specific type 1 numbers on this, for some reason).

Regarding the A1C: how many hypos were you having before you got the pump??? 
If the answer is "more than now" then you have your answer about why your 
A1C seems to have gone up. Then again, in clinical studies an A1C difference 
of 0.3% between tests (one after the other) is not statistically 
significant. If you are having less severe lows and less severe highs on a 
pump, you will reamain better off over the long-term than before you got the 
pump even if your A1C seems to be going up a bit.

Take care,

Melissa
Type 1 13+ years; MiniMed pumper 7.5 years; Animas pumper 2.5 years

----Original Message Follows----
From: "Alison C H Jones" <email @ redacted>
Reply-To: email @ redacted
To: <email @ redacted>
Subject: [IPk] Test Results
Date: Fri, 14 Jul 2006 09:33:46 +0100


Hi,
This morning I got a copy of the letter that my diabetes specialist sends to
my GP after he has seen me, (first time I've had one of these in 30 years
!)I've got an idea what most of it means , but what is the "normal " level 
for
triglycerides? - mine are 0.6mmol/l. and my creatinine level is 48umol/l - 
is
that OK? What should my total cholesterol level be? I'm at 4.4mmol/l and
apparently this is too high, though my HDL cholesterol is 2.2mmol/l .

Dr Rob runs through my general results when I see him, but I'm quite
interested in the details and won't be seeing him again for a couple of 
months
!

Rather sadly my HbA1c has crept up from 6.5% before the pump to 6.8% !! Not
quite the way I was hoping it would go though I presume that was down to
getting my basal & bolus levels correct.

Hope that someone can help.

Kind regards

Allie
.
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