You will soon have role playing cards available for your doctor's visits. The conversation is scripted with four questions and the answers as to whether or not you should be on a statin. Two can play, but millions will have a chance of their very own!

The pocket cards are intended to empower patients to determine whether they should or should not take a statin. Statins are cholesterol lowering drugs that supposedly reduce the risk of heart attack. Diabetics are typically at a higher risk for heart attack. The card includes answers to four questions: (1) What is your risk of having a heart attack in 10 years? (2) What are the benefits of taking statins as compared to not taking statins? (3) What side effects can you expect from statins? (4) What do you want to do now?

If the risk of having a heart attack is very small, a pill that reduces that risk may not be worth it, but if the risk is really high, lifestyle changes (or a pill) might sound compelling. Once a patient has a sense of the potential dangers and benefits they can make an informed choice. I hope the cards come equipped with the source of the funding for this study: Mayo Clinic and the American Diabetes Association. I wonder if that's the underhanded way to say this study was funded by Merck, Pfizer, and GSK?

Last time I checked -drugs weren't cool, but according to a recent study, within the last 3 years, the number of teens using type 2 diabetes drugs has soared.

Medco, the largest US drug benefits manager, found the number of children taking medicine for type 2 diabetes more than doubled between 2001 and 2005. An analysis of prescription data found a 146% increase over four years in young people aged 10-19 taking type 2 diabetes drugs, and 115 % increase in all children in the survey. Children on diabetes medicines also faced other serious problems. About 17% of the boys and 13% of the girls were on drugs for high blood pressure; 5% of both were taking cholesterol-reducing drugs; and nearly 20% were taking narcotic pain relievers, drugs for respiratory conditions and antidepressants. Medco reviewed over 500,000 children each year. Of those aged 10-19, about 1.47 per 1,000 were taking type 2 diabetes drugs with a clear rising trend.

I'm so glad I'm not a teenager any more. These days it's not about abstaining from drugs. It's about the type of drugs you use. Just because your doctor is the one prescribing it doesn't mean you have to succumb to the peer pressure of drug use. I found an appropriate Chinese proverb for this blog: it is easy to get a thousand prescriptions but hard to get one single remedy. Put that in your pipe and smoke it.

Researchers defined a link between high insulin levels and defective lipid metabolism but the cause may not be exactly what you think. According to a study published in June, 2005 -- this could be due to their choice in blood sugar lowering medication.

The conclusion of the study identified obese insulin-resistant subjects taking metformin (brand names Glucophage, Diabex, Diaformin, Fortamet, Riomet, Glumetza) and rosiglitazone both improve insulin sensitivity (increase insulin production) but DO NOT improve lipid metabolism. Rosiglitazone (brand name Avandia) may have a detrimental effect on chylomicron metabolism

Blood vessels of insulin-resistant rats build up a substance called chylomicron cholesterol following a high fat meal. Because the rats are insulin-resistant, more insulin (in the form of an anti-diabetes pill) is required to clear sugars and fats from their bloodstream. Higher insulin levels reduced the rate of chylomicron removal from the blood stream following a meal. This slower clearing rate increased the chylomicron particles sticking around the blood vessels, leading to arterial plaque build up and heart disease.

Knowing that high levels of insulin are associated with elevated levels of chylomicron cholesterol, researchers will use this information to try to figure out how this happens.

Why would they do that? The answer was already explained in June, 2005. Oh it must be because arterial plaque builds differently in Australian's on anti-diabetic pills than it does in American's on anti-diabetic pills. We should all thank the good folks at GlaxoSmithKline, Bristol-Myers Squibb, Pfizer and Merck. Without their medicine -- how would anybody ever know about this stuff? First you're on an anti-diabetic pill, then you're on cholesterol lowing pill, what's next? Of course -- the blood pressure!!

How many people are Gold Star type 2 diabetic patients?

Hot off the press: some new information about the sometimes murky and confusing subject of cholesterol. According to a new study, lowering LDL, the so-called "bad" cholesterol, even lower than currently recommended levels could reduce the likelihood of stroke or heart attack for diabetics and people with heart disease. The method: up the dose for greater effectiveness.

A while back, research indicated that people with stable coronary disease would benefit from a higher than normal dose of the cholesterol-lowering drug Lipitor. The researchers have since taken a close-up look at how similarly high doses would benefit diabetics. The result: a twenty-five percent reduction in death, stroke, heart attack and cardiac arrest in study participants who were taking the higher dose.

Details are being published in the latest issue of Diabetes Care (June 2006).

According to a new report, diabetics who also suffer from heart disease may benefit from taking a high dose of the cholesterol-lowering statin drug Lipitor (atorvastatin). This is the opinion of researchers at the University of Glasgow, whose report on the study has been published in Diabetes Care (June 2006).

Oh, and when these guys say they recommend a high dose, they aren't kidding around: 80mg daily as opposed to the normal Lipitor dose of 10mg daily. Data suggest that the switch could lower major cardiovascular events by a very significant twenty-five percent. In fact, patients with heart disease who do not have diabetes also benefit from a higher dose, but diabetics are at a much greater risk for heart issues.

If you're diabetic and have heart disease, don't get your hopes up that this could help your situation. Not yet, anyway. The researchers say that a definitive study is still necessary before doctors could start changing patients' prescriptions.