A medical story for the forum:

[Ms. Toad]

41. I haven't read that study -

but my cholesterol is high and I'm diabetic. My diabetes is hereditary (every descendent of my maternal grandfather who is my age or older has diabetes). There is zero history of heart disease in any of the individuals with diabetes. In the previous generation - my mother is 93, my uncle just died of non-heart-related causes at 97-ish).

I am not willing to go on statins because they work by (1) blocking the production of cholesterol, forcing the body to pull the cholesterol it needs from the blood through the vein walls - which also blocks the production of other things the body needs (but can't pull from the blood - like CoQ10), and (2) hardening the arteries as a consequence of pulling the cholesterol through the veins and (3) I have 0% cardiac calcification.

We don't actually know if the correlation between high serum cholesterol and heart disease is one of causation, versus both being symptoms of an underlying cause/condition. My doctor is certainly reasonable in asking me to consider statins. On all evaluations which do not use diabetes as a overriding factor, the rest of my history (cholesterol numbers, age, gender, diabetes as a factor, family history) puts me in the discussion, not recommendation, category.

What is unreasonable is his refusal to consider diabetes as one factor - to be balanced against all others. I don't know if insurance is the reason for rote treatment (as opposed to customized), but he has told me more than once that he is getting dinged by insurers for not having all of his diabetic patients on statins.