Statin Answers

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Diabetes and Statins

Taking statins increases the risk for diabetes. If you take a statin drug, all other things being equal, you will be more likely to develop Type II diabetes. A large meta-study recently concluded statin use increases the risk by 9 percent.

A large meta-analysis (study of studies) concluded that the risks of diabetes mellitus and its effects are small enough that the patients with cardiovascular disease or moderate to high risk for cardiovascular events should not be affected. The authors estimated 255 patients would have to be treated with statins for 4 years for one to develop diabetes, and that risk is worth it for the patients with cardiovascular disease.

The lipophilic statins (atorvastatin, cerivastatin, fluvastatin, lovastatin and simvastatin) may indirectly impair insulin secretion and promote insulin resistance. Pravstatin (a hydrophilic statin) appears to cause an increate in insulin sensitivity. Rosuvastatin - also hydrophilic -appears to have no overall affect on insulin sensitivity in people with a history of hyperlipidemia or with metabolic syndrome.

As with other side effects, the doctor must weigh these risks with the probable or potential benefits of statins.

Scientific inquiry into this question continues, with growing exidence of a connection between statin use and the risk for diabetes. As statins have been used over the years by tens of millions of people, more about their side effects is becoming known.  Initial studies suggest that a low percentage of patients (less than 1 percent) have this statin-induced diabetes susceptibility – it’s hard to tell because diabetes is so common – but the large number of people using statins for years at a time has raised this connection as a public health concern. Writing in the New York Times, Eric Topol said:

"More than 20 million Americans take statins. That would equate to 100,000 new statin-induced diabetics."

The FDA now requires the drug companies to mention the risk of diabetes on the package inserts that come with statin pills. Few patients read these, so the more important thing is that medical professionals (doctors and nurses) are aware of the possibility of diabetes and can communicate them to patients. The European Medicines Agency (EMA) has also issued a warning in response to studies showing an increased risk. Given the demographics and health of statin patients, many or most are typically checked for blood sugar levels on a routine basis.

An observational study found some evidence that older women are more likely to develop diabetes when they are taking statins. There is a no significant difference among the types of statin drugs on this.

Statin Use in People Who Already Have Diabetes

People who have diabetes (either Type I or Type II) can benefit from stain usage the same way non-diabetics can. Given that diabetics are at increased risk for adverse cardiovascular events compared to non-diabetics with similar cholesterol levels, statins are especially valuable for those with diabetes. Article: Statin Therapy in Patients with Diabetic Nephropathy

Another study suggests that statins can help the tendency of wounds to heal in people with diabetes.

The American Diabetes Association (ADA) estimates over 29 million Americans have diabetes, although most of them have never been diagnosed. The World Health Organization says over 400 million people have it across the globe.

Under the 2013 guidelines for cardiovascular risk management put out by the ACC/AHA, all diabetics past age 40 should be on a statin medication. An article in the ADA journal Clincial Diabetes says "at least 60% and arguably 80% of people with diabetes will eventually succumb to cardiovascular disease (CVD)" A meta-analysis of several studies showed that treating diabetic patients to lower cholesterol for 5 years resulted in reduced number of heart attacks and deaths from cardiovascular disease.

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