Statins for high LDL when already at risk of type II diabetes

Medical Q&A [Moderated]
1

Would you have a strong opinion about prescribing statins for:

48y/o male lifter, 195lb, 27% bf.
High LDL (124), total cholestorol 196
Family history (father) of type II diabetes
out-of-range blood glucose (103), two years in a row.
Other labs (including C-Reactive Protein) normal, except high creatinine and slightly low eGFR (58)
Lousy diet, minimal cardio

I feel crappy when I take lipitor (already bad muscle soreness gets much worse, plus more-than-usual detraining on missed workouts), but also don’t want to die, but also don’t want diabetes.

2

Based on current recommendations, you would probably not be considered high enough risk to benefit from these medicines, although I’d need more information to say for sure (specifically your race, HDL-C, systolic blood pressure and any blood pressure medicines, and smoking history).

3

Based on this information, and on current guidelines, your estimated 10 year risk of a cardiovascular event is probably less than 3%. This is well below the threshold we typically use to guide medication decisions.

4

Thanks so much, Dr. Baraki.