Statins Associated With Significant Increase in Diabetes Risk
By Michael O’Riordan, from WebMD
Statin use in postmenopausal women is associated with a significantly increased risk of diabetes mellitus, research shows. New data from the Women’s Health Initiative (WHI) hints that the risk of diabetes is higher than suggested by previous studies, with investigators reporting a 48% increased risk of diabetes among the women taking the lipid-lowering medications.
“With this study, what we’re seeing is that the risk of diabetes is particularly high in elderly women, and this risk is much larger than was observed in another previous meta-analysis,” senior investigator Dr Yunsheng Ma (University of Massachusetts Medical School, Boston) told heartwire. “For doctors treating patients, we would like them to really look at the risk-benefit analysis, especially in different age groups, such as older women.”
Annie Culver (Mayo Clinic, Rochester, MN), a pharmacist and lead investigator of the study, published online January 9, 2012 in the Archives of Internal Medicine, said that “close monitoring and an individualized risk-versus-benefit assessment is really a good thing, as well as an emphasis on continued lifestyle changes.” Culver added that as the population ages, and because these patients have a higher vulnerability to diabetes anyway, monitoring for diabetes in statin-treated patients becomes more important.
“I think the risk [of diabetes] is definitely there for statins,” Culver told heartwire, “and I think physicians are probably aware of this risk. I think we now need more information and more research about precisely how this risk translates to different people and different populations.”
Previously Published Data on Statins and Diabetes Risk
Recently published data reported by heartwire highlighted the potential risk of diabetes with statin therapy. In June, Dr Kausik Ray (St George’s University of London, UK) and colleagues published a meta-analysis of PROVE-IT, A to Z, TNT, IDEAL, and SEARCH–five trials testing high-dose statin therapy– and found a significant increase in risk of diabetes with higher doses of the lipid-lowering drugs.
A meta-analysis published in the Lancet in 2010 by Dr Naveed Sattar (University of Glasgow, UK) also showed that statin therapy was associated with a 9% increased risk of diabetes.
In the present study, Culver, Ma, and colleagues analyzed data from the WHI, an analysis that included 153 840 postmenopausal women aged 50–79 years old. Information about statin use was obtained at enrollment and year three; the current analysis includes data up until 2005. At baseline, 7.0% of women were taking statins, with 30% of women taking simvastatin, 27% taking lovastatin, 22% taking pravastatin, 12.5% taking fluvastatin, and 8% taking atorvastatin. During the study period, 10 242 incident cases of diabetes were reported.
In an unadjusted risk model, statin use at baseline was associated with a 71% (95% CI 1.61–1.83) increased risk of diabetes. After adjusting for potential confounding variables, the risk of diabetes associated with statin therapy declined to 48% (95% CI 1.38–1.59). The association was observed for all types of statins.
“The association between diabetes risk and statin therapy was not observed with any one type of statin, and it seems to be a class effect,” said Ma.
A significantly increased risk of diabetes was observed in white, Hispanic, and Asian women (an increased risk of 49%, 57%, and 78%, respectively).
Among African Americans, who made up 8.3% of the population studied, there was a nonsignificant 18% increased diabetes risk associated with statin use at baseline. Statin use and diabetes risk was also observed in women across a range of body mass indices (BMIs30.0 kg/m2).
In an editorial, Dr Kirsten Johansen (University of California, San Francisco), Editor of the Archives, noted that the increased risk of diabetes in women without CVD has “important implications for the balance of risk and benefit of statins in the setting of primary prevention in which previous meta-analyses show no benefit on all-cause mortality.”
Ma agreed, noting to heartwire that statins are used with increasing frequency, including in primary prevention, and–based on the JUPITER trial–in patients with normal LDL cholesterol, but elevated C-reactive protein (>2.0 mg/L). In the present study, baseline statin therapy was associated with a significant 46% and 48% increased risk of diabetes in women with CVD and without CVD, respectively.
Just 7% of women in the WHI study were taking statins in the analysis, but today that number would be significantly higher, making the potential risk of diabetes at the population level much more widespread.
Ma said that physicians need to evaluate the risk of diabetes as well as the potential benefits of statin therapy in elderly female patients, and start statins after lifestyle interventions have been attempted.
Dr. Pinna says:
Absolutely nothing is FREE in the Universe! If you lower your cholesterol by taking a drug, your cost is an increased risk of diabetes.
The Statins (Lipitor—the most famous) work on your liver, interfering with the production of cholesterol. But, the liver is where glycogen (starch molecules containing glucose/sugar) is located. We use glycogen constantly as a source of energy for our body.
It is becoming quite clear that the statins, while lowering cholesterol, are raising the release of glycogen thereby increasing blood sugar and causing diabetes.
Although this study targeted women, most certainly, men are affected as well. The target level of Cholesterol of 200mg/percent is too low. The 200 level was unknown in medicine prior to the advent of the introduction of the statins by the major pharmaceutical companies.
In the early part of the 20th. century, a normal cholesterol was 200 plus the age of the patient. It was no coincidence that the 200 target only became established as billions of dollars were earned by the drug companies.
If a patient has an abnormally high cholesterol, then lifestyle changes should be tried.
HOW DO YOU LOWER CHOLESTEROL WITHOUT PILLS?
Very simple! Follow a Japanese style diet. Sea food and veggies and very little fatty meat. Walk or exercise.
Meditate about Buddha said:
“If the love within your mind is lost and you see other beings as enemies, then no matter how much knowledge or education or material comfort you have, only suffering and confusion will ensue.”