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Errr.....not sure about that; though I don't know your age and other stats et al. If you were a Type-II, obese male in his 40s or more (not that I know any of those, understand), I would, all things considered, Disagree with that conclusion. Especially the statin; but even the ACE inhibitor.
Look, not a 6-month period goes by without someone, somewhere, finding out that statins, in general, seem to have yet another positive effect on the over 40 crowd (and definitely the over 50 crowd. The British National Health Service, for example, is seriously considering making taking a statin over 50 as 'standard'). Anyone who is a Type II diabetic...especially males...are, BY DEFINITION, at-risk individuals. As my own PCP put it, 'you're male, type 2...you already have heart disease; you've already had your first heart attack. And we base everything else on that'. (I haven't had a 'real' heart attack, per se, yet. If/when it comes, it will come against a heart that's already 'suffered', is what he....and the Diabetes Association...are saying).


Generally true.

Diabetics suffer damage to kidneys on a microscopic level (at the tiny tubules that connect the "filter" and the filter itself - the glomerulus). This leads to loss of protein in the urine (proteinuria), and gradually accelerating kidney damage. This protein can be measured even at an early stage with a test called urine microalbumin. Angiotensin-converting-enzyme inhibitors, "ACE-I", by their effect on the tubules connected to the glomerulus can greatly slow this phenomenon and are said to be "renal protective" (the word renal referring to kidney). If you have microalbuminuria, you should be on ACE-I, though ask your doctor about the potential side-effects (usually minor and reversible). An alternative to an ACE-I is a simlar class of drugs called angiotensin receptor blockers or "ARB"'s which also provide this renal protection. Ask your doc if you might benefit from one.

By the way, the Joint National Committee on Hypertension (JNC), in its latest recommendations, have suggested that a diabetic's blood pressure should be 120/70 (or close) to greatly reduce stroke, renal and cardiac problems - this has been borne out by quite a few studies. ACE-I's and ARB's are anti-hypertensives and are considered first-line BP meds for diabetics (some restrictions apply which your doc can tell you about).



Statins are now the most prescribed drug in human history; and it looks like they will continue to grow in usage. Small-dose usage by people who clearly already have a risk factor...and Type-II diabetes is one of the biggest ones....is erring on the safer side, in my view (all things considered of course).


Absolutely true to this point. I've discussed statins here several times and prescribe them extensively, including to myself. I think I mentioned previously that a recent study strongly suggested that the statin Zocor, made by Merck, was successful in lowering the risk of 1st heart attack in diabetics even without elevated cholesterol at baseline (it was the only statin in the study and will probably be a class-effect). Ask your doc about a statin and the monitoring and possible side-effects that may go with it.

ab - am I being helpful to the board?

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