Statin Therapy for Diabetes
What you need to know
What Are LDLs and HDLs?
These are both terms for a combination of fat and proteins that circulate in your blood. Your doctor can monitor these with a simple blood test. LDL (Low-Density Lipoprotein) represents your “bad” cholesterol. LDLs can form plaques inside your blood vessels leading to clogged arteries. When the arteries become clogged it can cause a heart attack or stroke. HDL (High-Density Lipoprotein) represents your “good” cholesterol. HDLs act as hunters for LDLs. The HDLs will carry your LDLs to the liver to be removed from your body. Increasing levels of HDLs is just as important as lowering LDLs in preventing heart attacks and strokes.
What Are Statins?
Statins are drugs that help to block the liver from making cholesterol. Blocking this will decrease your LDLs, but that’s not all. Statins have also been shown to improve the lining of your blood vessels, decrease inflammation in your blood vessels, and reduce the chance of clots forming in your blood. Statins are one of the most effective medications for preventing stroke and heart attack. Depending on your risk factors and past medical history your doctor will decide what intensity of statin you may need.
|High-intensity statin therapy
lowers cholesterol by ≥50%
|Moderate-intensity statin therapy
lowers cholesterol by 30 – 50%
|Low-intensity statin therapy
lowers cholesterol by < 30%
|Atorvastatin (Lipitor®) 40 – 80 mg a day
Rosuvastatin (Crestor®) 20 – 40 mg a day**
|Atorvastatin (Lipitor®) 10 – 20 mg a day
Rosuvastatin (Crestor®) 5 – 10 mg a day**
Simvastatin (Zocor®) 20 – 40 mg a day
Pravastatin (Pravachol®) 40 – 80 mg a day
Lovastatin (Mevacor®) 40 mg a day
Fluvastatin XL (Lescol XL®) 80 mg a day
Fluvastatin (Lescol®) 40 mg twice a day
Pitavastatin (Livalo®) 2 – 4 mg a day**
|Simvastatin (Zocor®) 10 mg a day
Pravastatin (Pravachol®) 10 – 20 mg a day
Lovastatin (Mevacor®) 20 mg a day
Fluvastatin (Lescol®) 20 – 40 mg a day
Pitavastatin (Livalo®) 1 mg a day**
* Statin use in patients > 75 years old may be warranted
** Only available as brand medication
Stone N, Robinson J, Lichtenstein A et al. 2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2013;129(25_suppl_2);S1-S45.
Why Statin therapy for patients with Diabetes?
People with diabetes have more than twice the risk of developing cardiovascular disease compared to people without diabetes. Even if your LDL and HDL levels are within normal range diabetics are more prone to blood vessel damage, which increases the risk of cardiovascular disease. These damaged blood vessels will increase the risk for high blood pressure and plaque buildup in the arteries. The use of statins has been shown to decrease the incidence of heart attack by 36% and decrease the incidence of stroke by 48%. There is an individualized screening tool your doctor will use to determine which one is best for you.
What Are The Risks?
For most people statins are very well tolerated. The most important side effect we tell patients to be aware of is muscle aches and pains. This is one of the most common side effects, but still happens in less than 10% of patients. The benefits to the patient in regard to decreasing heart attacks and strokes almost always outweigh the potential risk for side effects. If this occurs the doctor will either lower the dose or try an alternative statin. Severe muscle pain, known as rhabdomyolysis, is a very rare side effect.
Other side effects that may occur include:
These should subside within a week or two of starting the medication
Diet and exercise is important for everyone, but for patients with diabetes it can help improve blood glucose control, cholesterol levels, and help stabilize blood pressure.
How Do I Get Started?
- Go for a 20 min walk 3 times per week
- Take the stairs instead of the elevator
- Replace 1 unhealthy snack with fruit or vegetables
- Increase whole grains and fiber like oatmeal, wheat bread, brown rice, beans, and nuts
- Replace 1 soda with a bottle of water
- Wear long clothing and tuck pant legs into socks
- Use insect repellent containing DEET on all exposed skin
- Use permethrin spray on clothing, shoes, hats, and outdoor items such as tents and sleeping bags
- Upon coming inside, take a shower and put worn clothes in dryer for 10 minutes to kill off any lingering ticks
- If you are going somewhere where reports of Lyme’s
- Disease are high, talk to you doctor about getting
- preventative antibiotics like doxycycline
What to Expect
- Little to no pain
- A small bump lasting about 2 days
Treatments – OTC
- Wash hands and bite site after removing the tick
- Apply one application of OTC antibiotic ointment
How to Remove Ticks
- Grasp the tick as close to the skin as possible
- Pull straight upwards without twisting or crushing the tick
- Keep steady pressure until the tick lets go
- If any part of the tick remains in the skin, clean the skin with rubbing alcohol and scrape off what you can with tweezers or a needle
Using a Twisting Device:
- Slide slotted part of took along skin and around the ticks head
- Twist tool until the tick release from the skin
- Lift tick and tool away from skin
Products at Patton Pharmacy
- DEET Bug Spray
- OFF Family Care
- Coleman 100 Max Insect Repellent
- Permethrin Spray
- Sawyer Insect Repellent Clothing
- Antibiotic Ointments
- Tick Removers
- Tick Tornado
When to See the Doctor
- If you cannot get the tick removed from the skin
- A rash or fever starts over the next 2-14 days
- A new redness starts over 24 hours after the bite
- Signs of infection
- A red ring or bull’s eye rash appears around the bite
Treatment for Lyme Disease
- Antibiotic treatments for Lyme’s Disease in adults and children over 8 years old include Doxycycline, Amoxicillin, and Cefuroxime
- Children less than 8 or women who are pregnant should not take Doxycycline but can still use Amoxicillin or Cefuroxime
- Treatment can last from 10 to 28 days depending on the medication used and what stage the disease is in
- If you get bitten by a tick, your doctor may prescribe a preventative dose of doxycycline within the first 72 hours after removing the tick depending on the likelihood of Lyme’s Disease development
What is Asthma?
Asthma is a condition that affects the respiratory tract and the ability to breath. Anyone can develop this disease, however, this condition is often diagnosed in children and adolescents. Asthma is characterized by increased mucus production and inflammation of the airways leading to narrowing of these passages. An “asthma attack” occurs when these pathological changes are aggravated, oftentimes in the case of exposure to one’s triggers, and can severely limit the ability to breathe. Although the exact cause of asthma is unknown, certain trends have been identified that put some at risk than others. Those who have a family history of asthma are at higher risk of developing the disease. Also, people who have been exposed to toxins, such as environmental pollutants or cigarette smoke, or have been previously diagnosed with allergies are at higher risk of developing asthma. Although asthma has no cure, control of symptoms and exacerbations can be achieved with proper treatment and adherence to prescribed therapies. Keys to successful management of this disease are to identify what worsens your symptoms or causes an attack and learning proper inhaler technique for prescribed medications.
What triggers asthma?
When do you see asthma symptoms?
- During or after exercise
- When exposed to common asthma triggers
- During certain seasons
- After laughing or crying
- At night or early morning
Asthma is often managed using inhalers that deliver medications directly to the lungs to reduce inflammation, open the airways, and decrease mucus secretions. For mild cases, a “rescue” inhaler is used to provide quick relief when needed for attacks. In moderate to severe cases, a “maintenance” or “controller” inhaler is used on a daily basis to provide long-term control in addition to a “rescue” inhaler is used for attacks.
Properly using your inhaler helps ensure the medications are able to work in your lungs. Each inhaler has unique instructions and may require different administration techniques. A controller inhaler should be used daily to manage symptoms and prevent attacks. A rescue inhaler should be used when you are experiencing an exacerbation of your symptoms- likely due to one of your triggers. The primary way to prevent asthma attacks is to identify and avoid factors that trigger them. If you utilize your rescue inhaler more than two times a week, you should notify your physician as this may be a sign that your asthma is not adequately controlled. Ask your pharmacist or physician for instructions or visit www.use-inhalers.com for more information on inhaler use
What to ask yourself?
- Do I experience shortness of breath, chest tightness, coughing, or wheezing?
- How do I use my inhaler correctly?
- What happens if I still have trouble breathing?
- When do I need to see my doctor?
- Do I use a rescue inhaler more than twice a week?
- What’s my asthma action plan?
- Could I be making a mistake with my inhaler administration?
- Does my inhaler need “primed”?
- Do I know what triggers my asthma symptoms?
If you think you might have asthma, have been diagnosed with this condition, or have questions regarding your medication please speak to your doctor or pharmacist.
- With 3.5 million diagnosed cases in the US
- 2 million people diagnosed annually
- Skin cancer is the most common form of cancer in the US.
- It is one of the most preventable cancers as well
- Asymmetry: One part of a mole or birthmark doesn’t match the other.
- Border: The edges are irregular, ragged, notched, or blurred.
- Color: The color is not the same all over and may include shades of brown or black, sometimes with patches of pink, red, white, or blue.
- Diameter: The spot is larger than ¼ inch across – about the size of a pencil eraser.
- Evolving: The mole is changing in size, shape, or color
Other things to look for:
- New spots or moles
- Any spot that doesn’t look like others on your body
- Any sore that doesn’t heal
- Redness or new swelling beyond the border of the mole
- Itching, pain, or tenderness
- Oozing, scaliness, or bleeding
If you are experiencing any of these, talk to your pharmacist or reach out to your doctor to make an appointment. The earlier skin cancer is caught the better.
- Use a broad-spectrum (UVA/UVB) sunscreen SPF 15 or higher every day. For outdoor activity, use a water-resistant sunscreen SPF 30 or higher.
Apply 2 tablespoons of sunscreen to your entire body:
30 minutes before going outside.
Reapply every 2 hours. immediately after swimming or excessive sweating.
- Avoid UV tanning booths
- Cover up with hats, sunglasses, and umbrellas.
- Seek the shade, when the sun is strongest 10 AM – 4 PM.
- Examine your skin once a month and see your physician annually for a professional skin exam.
Blood Pressure Screening Event
- Patton Pharmacy will be offering free blood pressure screening events
- Monday, May 15th 9am-5pm
- Tuesday May 16th 9am-12:30pm
- Wednesday May 17th 9am-4pm
What is High blood pressure?
Our blood vessels play a key role in the proper functioning of our body. Blood vessels transport oxygenated blood from our heart to the rest of our body, providing nutrients to our organs. High blood pressure is when the force of blood flowing through your blood vessels is consistently high. This is also known as hypertension.
How Common is High Blood Pressure?
- Affects an estimated 1 out of every 3 adults over the age of 20, or nearly 85 million Americans.
- Nearly 20% of people with high blood pressure are unaware that they have high blood pressure
Certain patient populations may be at an increased risk for developing high blood pressure. Risk factors include:
- Age: ↑ risk increases with increasing age
- Race/ethnicity: more common in African American adults
- Overweight: ↑risk in people who are overweight/obese
- Lifestyle habits: ↑risk in people with high sodium diets, lack of physical activity, elevated levels of stress
- Family history: A family history of high blood pressure ↑ your risk
Signs and Symptoms
High blood pressure is one of the few disease states that often presents with no obvious signs and symptoms. The lack of symptoms to accompany high blood pressure has led to the nickname, “the silent killer”. Several symptoms that may accompany high blood pressure are often nonspecific and include:
- Blurred vision
- Chest pain
There are numerous causes to an elevated blood pressure. Some of the causes may be modifiable and others may not. Common causes may include:
- Unhealthy lifestyle habits
- Certain medications
- Hormonal imbalances
- Other disease states
Uncontrolled high blood pressure can have many damaging effects on the body overtime. It is important to catch and treat elevated blood pressure early so that the long-term complications may be avoided. Complications include:
- Heart attack
- Eye damage
- Heart failure
- Peripheral artery disease
- Kidney disease
- Cognitive changes
High blood pressure is diagnosed for most patients when blood pressure readings are consistently above 140/90 mm Hg. Diagnosis is done through a blood pressure test which is quick and painless.
Treatment is dependent on the cause of the elevated high blood pressure. Blood pressure may be controlled through lifestyle changes and/or medications.
Maintaining a healthy lifestyle can help prevent high blood pressure. Things you can do:
- Eat a healthy diet & ↓ salt intake
- Limit alcohol intake
- Regular medical care
- Regular exercise
- Manage stress
- Check blood pressure regularly
- The American Heart Association & The National Institute of Heart, Lung and Blood Institute