Statins and Type 1 Diabetes in Women: Are They Really Necessary?
- Melissa Slemp
- 5 days ago
- 4 min read
If you're a woman over 40 managing type 1 diabetes, chances are you've heard this line at your endocrinologist’s office: “Because you have diabetes, we recommend a statin.” And just like that, you're left wondering—do I really need it? Is my cholesterol actually a problem? Let’s dig in.
In episode 99 of my podcast, I sat down with Kelly Schmidt—fellow type 1, functional dietitian, and my go-to for root-cause conversations—to unpack this hot midlife topic.
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Why Statins Get Pushed on Us
Many doctors see type 1 diabetes as an automatic high-risk ticket for heart disease. So statins, cholesterol-lowering meds, often get prescribed preemptively—even when your lipid panel looks pretty solid. This happened to my husband and even to Kelly herself. Her labs were stellar, yet her endo still recommended a statin based on type 1 duration alone.
But here's the thing: statins aren't one-size-fits-all. And while they can be life-saving in certain cases, blindly taking them “just in case” may not serve you well—especially without understanding your personal cholesterol story.
What Your Cholesterol Numbers Are Actually Saying
Let’s go beyond the basic HDL (“good”) and LDL (“bad”) labels:
LDL (think: litter) can be inflammatory and potentially harmful—but not always. The particle size and density matter more than the number alone.
HDL (the garbage truck) helps clean up the litter—higher is generally better.
Triglycerides often get overlooked but are key! They’re a powerful indicator of insulin sensitivity and blood sugar control.
Kelly recommends looking for a triglyceride-to-HDL ratio close to 1:1. If your triglycerides are 100 and your HDL is also around 100, that’s a great sign.
She also emphasized that high triglycerides can show up if you’ve recently lost weight (yay you!)—so context matters.
Blood Sugar Swings Can Mess With Cholesterol
This one hit me: wide glucose swings can increase inflammation and worsen cholesterol. Kelly explained that even if your A1C looks okay, big spikes and drops in blood sugar can elevate LDL and increase cardiovascular risk. That’s why standard deviation (how much your sugars swing) might be more meaningful than your A1C alone.
Ask for Deeper Testing
Before accepting a statin script, ask: What is the root issue here? Could this be inflammation, insulin resistance, or hormonal shifts?
Here are labs Kelly recommends you request:
High-sensitivity CRP (Hs-CRP) – marker of inflammation
Homocysteine & Ferritin – for cardiovascular and iron status
ApoA and ApoB – even better than standard cholesterol numbers
Cardio IQ or Lipoprotein Particle Testing – to look at particle size and risk more accurately
Unfortunately, these aren’t always standard—even though they should be.
Midlife, Hormones & Cholesterol: It’s All Connected
As estrogen levels decline in perimenopause and menopause, cholesterol can rise. Estrogen plays a role in clearing cholesterol from the body. Plus, declining gut diversity and increased insulin resistance in this season of life add fuel to the fire.
So if your cholesterol has crept up over the last few years, it might not be about your diet at all—it could be about your hormones, gut health, and inflammation.
Lifestyle First: 5 Things to Focus On
Here’s what Kelly and I agree on 100%—these are foundational for managing cholesterol naturally:
Eat close to the farm. Avoid trans fats and seed oils, and up your intake of omega-3-rich fish, fiber, and colorful veggies.
Lift heavy things. Strength training improves insulin sensitivity and supports hormonal balance.
Get quality sleep. Inadequate rest increases inflammation, cravings, and blood sugar swings.
Hydrate with electrolytes. Kelly recommends Buoy (especially with lemon or lime).
Minimize blood sugar swings. Aim for fewer spikes and dips to lower LDL and inflammation.
Supplements That Support Heart Health
If you're thinking beyond prescription meds, these are a few standouts:
Methylated B-complex – for energy, stress, and heart support
High-quality fish oil – rich in omega-3s for anti-inflammatory support
Probiotics – gut health is foundational
Berberine (short term) – supports insulin sensitivity (but don’t stay on it forever!)
Inositol & CoQ10 – helpful for metabolic and heart health
Always choose third-party tested, practitioner-grade supplements—and avoid buying on Amazon to ensure quality.
Visit my online store for professional-grade supplements—order anytime, no strings attached. Plus save 15%!
How to Talk to Your Doctor
If your endo is quick to write a statin prescription, try this:
“Can we look deeper into the root cause of my cholesterol numbers?”
“Are we addressing the inflammation, blood sugar swings, or hormone changes?”
“Would a statin be a band-aid—or is there data showing I truly need it?”
Your doctor works for you. Be curious, ask for data, and make decisions with your whole body and long-term health in mind.
🎧 Listen to episode 99 of my podcast, where Kelly and I go deeper into how cholesterol connects to type 1 diabetes, hormones, and lifestyle—and how to have an empowered conversation with your doctor.
You are the expert of your own body. Let’s keep learning and advocating—together.
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