Diabetes and high triglicerides question.

[leftyladyfrommo]

I have a friend with diabetes. She takes medication but is not on insulin.

She just had a blood test done and her triglicerides came back at 1200. That is way high.

The doctor phoned in a med for that but she won't get it because it will cost her $95 a month. She is already paying for blood pressure meds and her dibetes meds which are expensive because she had a terrible reaction to metformin.

Does anybody know about this?

[lostincalifornia]

1. Specifically she needs to address her trigliceride issue. 1200 is much too high, and can cause

problems with her liver and pancreas.

If she drinks alcohol, she should stop, and look into a diet that has a better choice of omega 3 fatty acids, along with other things.

As for her medications, Nicin can lower triglicerides, and should not be expensive, though she needs to be using it under the supervision of a doctor, to make sure appropriate lab tests are ordered. Statins are used mostly for cholesterol, LDL and HDL, they also lower triglicerides, and most of that class of drugs have a generic alternative which should be quite reasonable price wise

As for 95 dollars a month, she needs to investigate alternatives, and discuss this with her doctor.

It is imperative she does not ignore this

[TexasProgresive]

2. My doc thinks high triglicerides and diabetes are related

Triglycerides are fats composed of 3 sugar molecules. So it seems reasonable that high triglycerides can be caused by high blood glucose levels. My triglycerides were in the 500+ range which was high enough to cause a false positive on Red Cross's crappy hepatitis C test. I was prescribed Lopid but got hives after 12 days. Even getting my sugars down failed to get them much lower then 300- A couple of years ago I had a cardiac workup preparing for surgery. The cardiologist suggested I take Lovaza and purified fish oil- that got me down to less then 150.

Back then I read a lot of studies on triglycerides. One which sticks in my mind had to to with a drug trial on rats. The rats (Wistar fatty rats*) were given 10% high fruitcose corn syrup in their water to cause their blood triglycerides to increase so as to test the drugs abliity to decrease the triglycerides.

This is not the same study but linking anyway:
http://diabetes.diabetesjournals.org/content/45/6/806.abstract

I think that the whole discussion whether HFCS is good or bad does not take into consideration that people are not cookie cutter. Some of us are fatty rats and some of us are not. Those who are naturally lean with high metabolisms will not be harmed those who have lower metabolisms and tend to obesity will be harmed.

[leftyladyfrommo]

3. She is going to call the doctor again.

I did just read that you should always fast 9-12 hours before having a blood test and I don't think she did that.

She doesn't eat right. She tells everyone that she does. That she doesn't do carbs. But then she tells me that she ordered pizza and hate the whole thing.

Maybe this will be the wakeup call that will get her to really pay attention. The stuff I have been reading about this is pretty scary. She needs to be eating right and exercising and losing weight. And eating tons of fruits and veggies.

She won't listen to me so I am hoping her doctor will get on this and make her realize just how risky this behavior is.

I need to clean up my diet again, too. I do really well for a while and then slowly I fall off the bandwagon, too.

Thank you for the info.

[Erich Bloodaxe BSN]

4. Yeah, if you didn't fast as you were told to before any

given blood test, you will come back with various levels out of whack, and fats and sugar levels will especially be affected.

This can be tough for diabetics, especially those who are on drugs to lower blood sugar, as not eating that long can cause it to go too low. My dad can sometimes go to bed with a blood sugar of 250 and wake up in the morning at 60, if he ate something high carb in the evening that spikes levels, but also clears out quickly, and doesn't 'last' him through the night.

The best thing I've found to be helpful in cleaning up your lifestyle? Do it with other people. Eat more healthily WITH your friends, make gym dates or other exercise activities that will be fun with a friend, not stuff you are just 'grinding through' to be 'good'. Make the changes about enjoying life more, not some grueling 'routine' that you'll end up hating.

[leftyladyfrommo]

5. I don't think anyone told her to fast.

She just had an appointment to go in and she did. And then they took blood.

She has some other medical problems that make it really hard for her to do just normal stuff. She has a brain tumor behind her ear that is benign but it really affects her balance. It is hard for her to walk.

But she is perfectly capable of cleaning up her diet. But she really loves food. Eating good tasting food has been an important part of her life for a long time. And that's bread and pasta and pizza, etc. etc.

Staying on a diet is just really hard for some people.

[Erich Bloodaxe BSN]

6. That seems a bit odd, I think

if they actually planned to run a lipid panel. (Collect information on fats/triglycerides/etc in the blood stream.)

I'm not a specialist (even though I'm actually also in a phlebotomy course at the moment), but the general sense I've been given is that for most tests (apart from, for instance blood sugars taken one or more times a day or 'tolerance tests', such as the glucose tolerance test) you want to find a sort of 'baseline' reading for a patient - what their blood is like on an ongoing basis, not what it might be if they just happened to scarf down a double cheeseburger.

There are all sorts of tests, but according to pages 189-193 of 'Nurse's Quick Reference to Common Laboratory & Diagnostic Tests, 4th ed.' by Fischbach and Dunning, the 'common' triglycerides test is indeed a fasting triglycerides, with 'interfering factors' (that skew test values) including pregnancy, ingestion of alcohol or fatty foods, estrogen, oral contraceptives, cholestyramine, acute illness, colds, and flu skewing values up, and ascorbic acid, clofibrate, phenformin, metformin, aspariginase, and colestipol skewing values down.

Levels that high are also associated with increased risk of pancreatitis, so I hope your friend actually had just eaten something that had kicked her values up, and not that that value truly reflects her baseline blood state.

But again, maybe they wanted to know something other than just the standard test values. Only her doctor would know exactly what he wanted when ordering the test.

[EvolveOrConvolve]

7. It may seem counter-intuitive, but here's what I did

I was in a similar situation to your friend in that I have diabetes and my triglycerides were extremely high (near 600 on an 18 hour fast). I got my triglycerides down to 100 in only six weeks, and my total cholesterol number went from 300 to 185 in the same time period. I'm not saying that this will work for everyone, but it had amazing results for me.

1. Your friend should check her blood glucose levels OFTEN (fasting, pre-meal, 1 hour post-meal, 2 hour post-meal, and at bedtime), and write the numbers down so she knows exactly what her situation is. If she's often above 140, she should talk to her doctor ASAP about insulin. 140 seems to be the magic number where levels higher than it are a strong indicator of complications - neuropathy, amputation, retinopathy, heart disease, etc. Since she's not on insulin, I assume that she's a Type2 diabetic, but T2's can benefit from insulin treatment.
2. Stop eating carbs. Keep the total daily intake to less than 50 grams of carbs, and no more than 20 at any given meal. I eat only those foods that I know the exact (or near exact) amount of carbs, so I know exactly what my intake is going to be. Diabetes educators often tell patients to estimate the carbs in food by looking at the size, but that's a terrible way to track actual intake.
3. Eat a LOT of fat. This is where it gets counter-intuitive - most people think that a high fat diet leads to higher cholesterol numbers, but it's just not true. Most cholesterol in the body is produced by the liver, and problems with the liver (like what happens in diabetics) can cause extreme changes in the cholesterol numbers.
4. After each meal, do some light exercise. I walk for 10-15 minutes after every meal instead of doing one intense workout every day.
5. Stop eating carbs (can't stress this enough).

Other than insulin, I take zero meds for my diabetes and cholesterol. In fact, the only med I take is for high blood pressure, and it costs me $10 for a three month supply. I went from hideous cholesterol numbers to a normal range in only six weeks, and my blood sugars are near what a normal person experiences. I've also lost weight, even though I eat a 3,000 calorie/day diet.

[kdmorris]

10. I need a "like" button or something

This is exactly how I approached it, too. And, except for insulin and metformin, I take nothing else for my Diabetes. I do take thyroid meds, but other than that, nothing else.

The key is #5 though. (which is likely why you bolded it)

[2pooped2pop]

8. she needs to ask her doctor if there is something less expensive that could be ordered

instead.

[grasswire]

9. sounds like the rx is for Lovasz or the other similar med.

Those meds are high-strength omega 3 fish oil. That's all. So it is possible to work around them.

But first, she should be re-tested with a proper 12 hour fast prior to drawing blood.

Pay attention to her meds, too. Blood pressure meds are usually something that is available as generic, and very cheap.

Both her blood pressure and diabetes will be much improved if she stops eating excessive carbs and sodium.

[Thirties Child]

11. Mr. Thirties is in a similar health situation.

He has type 2 Diabetes, hypertension, a damaged kidney, can't take Metformin, has had high cholesterol and triglycerides since his early 30s. We're on Medicare and are fortunate enough to have insurance for medications. The one treatment that has helped control the triglycerides is Red Yeast Rice, which you can get at any vitamin shop. It might not help but would be worth trying.

[leftyladyfrommo]

12. Hopefully she will her back from her Dr. today.

She got the diet from the Mayo Clinic is going to try and stay on it.

I told her there has to be something she can take that she can afford.

Thanks for all the info.