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Taking atavarstatin for high cholesterol level. Had whiskey and high cholesterol diet. Worried for diabetes

Jan 2013
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Answered by

Internal Medicine Specialist
Practicing since : 2003
Answered : 1658 Questions
Dear sir
I am XXXXXXX.3 yrars back i came to know that my cholesterol level are hih / then Docctor prsecribes atavarstatin 10. i have been using the same since then. three months back my readings are
total cholesterol 300,hdl 36,ldl 147,vldl 55 try glicerides 400 ( all in mg%) fasting blood sugar 110, serum creatinine 1.3
then my friend doctor prescribed atavarstatin +finofibrate tablets
Yesterday 20.02.2013 i underwent blood analysis
total cholesterol 179,hdl 41,ldl 106,vldl 31 try glicerides 160 ( all in mg%) fasting blood sugar 260. serum creatinine 1.5
since now i am not diabetic but i astonished the reading goes to 260. before test date i attended a part where two large pegs of whiskey and high cholesterol diet taken. kindly advice me the reason and follow on treatment if i am diabetic. here i am transferred where doctor facility not available. iam 5.3 inches and 69 kgs weight. no diabetic symptoms are physically noticed by me. kindle advice me the further course of action and if medication if any.
Posted Wed, 13 Mar 2013 in Diabetes
Answered by Dr. Mayank Bhargava 34 minutes later
Welcome to XXXXXXX forum.

Let me explain your query one by one.

Do you have positive family history of early heart disease? (Early heart disease is considered in female <65 years and in male <55 years).
Do you have an active or sedentary life?
Are you a smoker?

With the available described symptoms and blood investigations, there appears to be some discrepancy in lipid profile report.
As you have mentioned that you were taking Atorvastatin since 3 years and you have elevated values when lipid profile was done few months back; How it could be possible that your deranged lipid profile comes to normal range after taking Atorvastatin + Fenofibrate for few months (while not correcting after taking 3 years)?

Treatment of Dyslipidemia (deranged lipid profile) is decided by presence / absence of risk factors.
Smoking, age > 45 years, sedentary life, first degree relative with positive early heart disease 140/90 mm Hg, Diabetes are considered as risk factors.

Normal BMI is between 18.5 -25.
Your BMI (Basal metabolic rate) is 26.95; which is slightly higher and you will be categorized in overweight.
You have one risk factor (overweight).

Presently you are non diabetic and at the age of 49 years, there is high chances of getting Type II diabetes (type I occurs before the age of 30 years) and this is generally diagnosed accidentally and with occurrence of complications such as heart attack, stroke, kidney damage, gastrointestinal symptoms.
As such type II diabetes has no symptoms.
You should go for repeat blood sugar both fasting and postprandial at regular interval.

Treatment of Dyslipidemia is decided by LDL level and should read ATP III guidelines.
If < 2 risk factors are present then LDL should be < 160 mg%.
If > 2 risk factors with 10 year risk of developing heart disease is <20% then LDL should be <130 mg%.
If > 2 risk factors with 10 year risk of developing heart disease is >20%, diabetes then LDL should be <100 mg%.
You can download calculator from following site: WWW.WWWW.WW For very high risk patients, LDL should be < 70 mg%.

As you have only one risk factor, your LDL must be below 160 mg%.
Your LDL is 106 mg% and as such there is no need of anti lipid lowering medicines.
Total cholesterol should be < 200 mg% (your value is 179 mg%) and triglycerides should be < 150 mg% (your value is 160 mg%).
So if we consider present lipid profile report, you should continue Atorvastatin as for maintenance therapy.

As you are overweight with slight derangements of lipid profile, you should reduce your weight.
Life style modifications are required in your case.
You should take low fat diet and live physically active life.
You should continue brisk exercise 30 minutes per day, at least 5 days in a week.

As there is some discrepancy, you should go for repeat lipid profile from a different lab.

You should consult with XXXXXXX medicine specialist/ cardiologist and should remain in touch.

Hope that helps.
Let me know if I can address any more concerns.
Take care,
Dr. Mayank Bhargava

Above answer was peer-reviewed by
Follow-up: Taking atavarstatin for high cholesterol level. Had whiskey and high cholesterol diet. Worried for diabetes 39 minutes later
please tell about the high sugar level of 260 as mentioned in my query. i am a non smoker and in my family history also reveals that they are non diabetics.i am leading normal life.I there any process to analyses sugar level foe past months.please advice me with regard to serum creatinine at 1.50. kindly advice

with regards XXXXXXX
Answered by Dr. Mayank Bhargava 1 hour later
Let me know that this 260 mg% sugar is fasting or postprandial (exactly 2 hours after meals).
Blood sugar 260 mg% whether it is fasting or postprandial suggests diabetes.
Fasting blood sugar > 126 mg% and postprandial blood sugar > 200 mg% is diagnostic for diabetes.
You should also go for glycosylated hemoglobin (HbA1c).
Raised serum creatinine may suggest effect of diabetes on kidney and you should go for ultrasound imaging for detection of preservation of cortico-meduulary differentiation and size of kidney.
Kidney size < 8.5 cm with loss of cortico-medullary differentiation suggests chronic kidney disease (CKD).
Although in diabetes, kidney size may be more than 8.5 cm in case of CKD.

Let men know the results of ultrasound imaging and glycosylated hemoglobin (HbA1c).

Best regards,
Dr. Mayank Bhargava
Above answer was peer-reviewed by
Follow-up: Taking atavarstatin for high cholesterol level. Had whiskey and high cholesterol diet. Worried for diabetes 3 hours later
Dear sir
Today at about 5.30 pm i consulted a physician. he chequed the sugar level in ocu check machine and noticed that at random sugar level is 452. he said that the tablet GLIBENCLAMIDE+ METFORMIN COMBINATION 400 twice a day for 5 days and after once again blood analysis has to perform and treatment will started afterwards.
please advice after consuming tablet how much time i have to waite for meal and also suggest dietwhat to eat and what not to eat. please
Answered by Dr. Mayank Bhargava 27 minutes later
Glibenclamide is a sulfonylurea: a group of medicines used for control of blood sugar.
Other sulfonylureas are glipizide and glimipride and different doctors have different experience with these drugs.
Selection of a particular drug depends on treating doctor's choice.
I am well acquainted with Glimipride with very good experience; keeping fasting at 100-110 mg% and postprandial around 140-150 mg%.
You should continue prescribed medicines as advised by your treating doctor.
Sulfonylureas are taken 30 minutes before meals (breakfast/ lunch/ dinner).
Currently medical nutrition therapy (MNT) is advised in which patient's diet is decided by total calories.
So you can take whatever you like but with limited calories.
You should consult with your treating doctor or dietitian for MNT.
Best regards,
Dr. Mayank Bhargava
Above answer was peer-reviewed by
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