Diabetes Self-Management Blog

A huge new American study found that older women who use statin (cholesterol-lowering) drugs have a 48% greater chance of developing Type 2 diabetes. So should women take these drugs? What about women who already have diabetes? What about men?

This statin–diabetes connection has been found before. British researchers analyzed five trials and found a significant increase in risk of diabetes with higher doses of statins. A Scottish study published in The Lancet in 2010 showed that statin therapy at any dose was associated with a 9% increased risk of diabetes, much less than in the new study, but still significant.

What is the effect of statins on already-existing diabetes? It seems likely that they should make it worse, since they can help give diabetes to people who don’t have it. But we don’t actually know that yet. And the protective effect on blood vessels might outweigh whatever negative effect the drugs have on diabetes.

The current study looked at 153,840 women aged 50–79 years old. Those who were using statins at enrollment in the study had a 71% higher chance of developing diabetes during 14 years of follow-up. After adjusting for various factors, that excess risk dropped to 48%. The diabetes risk was seen for all types of statins, not any one particular drug.

The risk was especially strong for Asian women (78% increase in risk,) with Hispanic (57%) and white (49%) women also strongly affected. African-American women had only an 18% increased risk. Interestingly, women with the lowest body-mass index (BMI,) appeared to be at higher risk of diabetes if they were on statins, compared with obese women. Go figure.

Kirsten L. Johansen, MD, an editor of the Archives of Internal Medicine, said the increased risk of diabetes has “important implications for the balance of risk and benefit of statins.” Johansen wrote that, for people who do not have cardiovascular disease (CVD), previous studies have shown no benefit on all-cause mortality. Their cholesterol may go down, but they are just as likely to die. So maybe, for people who don’t yet have CVD, statins have more risks than benefits.

However, Lancet study author Naveed Sattar, PhD, and his fellow authors said the extra diabetes risk from statins is low, compared with the reduction in heart attacks and strokes. He thought statins should still be used to prevent CVD, not just treat it.

Benefits of Statins
Statins are the most widely prescribed drugs in the world. A single drug, atorvastatin (Lipitor) made Pfizer $12.4 billion in 2008. Statins inhibit an enzyme called HMG-CoA reductase, which helps create cholesterol in the liver. So statins lower cholesterol levels, which may reduce risk of blood vessel disease.

Statins do more than lower cholesterol. According to statin advocate Richard Fogoros, MD, the drugs have an anti-inflammatory effect, which is valuable for people with diabetes. They reduce blood clotting and may reduce formation of plaque on the walls of arteries. They help to stabilize existing plaques, so they don’t break off and cause heart attacks and strokes. They may even shrink those plaques.

Although previous studies have shown that people on statins don’t live longer than non-users do, newer data seems to show that they may. One study looked specifically at people with diabetes on statins. They found that a significant reduction in cholesterol led to a 9% reduction in death rate. People without diabetes had a 13% reduction. People who lowered cholesterol on statins had 21% fewer heart attacks and strokes (fatal or nonfatal,) whether they had diabetes or not.

Statins have side effects, of course, and some are serious. The most common are muscle aches and pains, which can become serious muscle damage. Effects on the liver, digestion, skin rashes, and others have also been reported.

Should You Take Them?
According to Dr. Fogoros, “Experts agree that [in people who have CVD], statins remain an extremely important part of reducingā€¦risk. There is more controversy, however, in using high-dose statins in people who do not yet have CVD, but are at moderate risk of developing it.”

So the first thing to consider is, do you have CVD or not? CVD symptoms can include classic heart symptoms like chest pain (angina) and shortness of breath. They also include pain, numbness, weakness or coldness in your legs or arms. Sexual symptoms like erectile dysfunction and vaginal dryness can also be due to CVD. But many times CVD is not officially diagnosed until your condition worsens to the point of heart attack, stroke, or heart failure.

I think that realistically, anyone with Type 2 diabetes, and anyone who has had Type 1 for a long time probably has some CVD. But your cholesterol levels are also an important piece of the discussion. If your total cholesterol or your LDL (“bad”) cholesterol is not high, statins might not be worth the extra diabetes problems, even if you have some CVD.

Sex and ethnicity also matter. It seems from the recent studies that women gain less benefit from statins and have more risk of diabetes. Perhaps women should be slower to start statins than men. Also, the new study seems to show that Asian women are particularly likely to develop diabetes on statins, so perhaps they should be the last to take them. I couldn’t find studies looking at Asian men’s risk for diabetes on statins.

Although current recommendations are for most people with diabetes to be on statins, perhaps more research is needed, especially for women and people without CVD symptoms.

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Comments
  1. This is a most curious set of results.

    For me , Ihave gone from rotting mess since 2007 to today where my a1c is down, kidneys stable and back on track.

    My a1c down from 13.4 to 6.4 and weight down.

    From my experience and my results and teh data and articles you quote, I am curious of the roll of statins as I have been on for 4 last years.

    What we have here is a statistical connection but did not I see any other causitive science and concerns. please advise

    Posted by jim snell |
  2. This was a great article noting that statin therapy may not be the best therapy for a multiple patient profiles. Some many times the root problem has not been addressed and a band aid has been applied. New information that I recently discovered supporting Arterial Health as an alternative to statins. If we focus on the vehicle that holds the plaque that is the root cause of so many problems why not focus on that area. Would love to hear your thoughts….

    Posted by greathealthinspired |
  3. Jim, the study authors’ conclusion was that costs and benefits need to be weighed for using statins in different people. In your case, the benefits seem to be high and the costs low, so keep on with what you’re doing! It’s inspiring. In general, I think if something’s working for you, don’t change it because of a study.

    As far as HOW statins provide their benefits or increase risks of diabetes, all we know is how they lower cholesterol. The rest of their function is not understood as far as I know. But they do seem to considerably lower risk of strokes and heart attacks.

    GHI, I don’t know what Arterial Health is. Tell us more.

    Posted by David Spero RN |
  4. I think I’m one of the high percentage of older women who developed Diabetes. I’ve been on statin drugs for nearly 30 years. In the past 7 years I have become diabetic to the point that I am on insulin to keep it in control. I have a decent BMI of 25 and I exercise regularly. Diabetes does not run in my family.

    The doctor insisted I get on a statin when I was 35 ‘to save my life’. I advised him that my Grandmother lived to 97 with high cholesterol. My mother is now 80 and very active and healthy. Her cholesterol runs 300. The drug that was supposed to ’save’ my life has given me diabetes, which really messes with my quality of life.

    I think I hate modern medicine!

    Posted by linda |
  5. At the age of 60, I was prescribed a statin drug several years ago. I took the Lipitor for about 10 days and had a severe reaction - terrible muscle pain centered around my waist, upper back and shoulder. I stopped the statin and the pain receded. However, exactly one year later, I was diagnosed with sudden traumatic type 1 diabetes. There is no diabetes in my family and my blood sugar had always been normal. The only explanation for this sudden type 1 and failure of my insulin producing cells is directly related to the statin medication and my reaction to it. I have been waiting and waiting for a report to come out linking statins to diabetes - finally!!

    Posted by Vicki |
  6. I have never had high cholesterol, but when I was diagnosed with diabetes 6 years ago, the first thing the doctor did was put me on a statin which lowered my cholesterol even more. I developed muscle cramps and was switched to a different statin and a lower dose. When I started getting muscle cramps again, I was put on yet another statin. Two months ago, I quit taking them altogether, no more cramps. But my heart doctor wants me to take them again. I already have type 1, will taking a statin cause me to develop type 2 as well?

    Posted by Becky |
  7. I am a 70 year-old female, and in my personal situation, I was prescibed Lipitor in April, 2006, at age 65 because I had total cholesterol readings around the mid 200s. By November, 2006, I was diagnosed with diabetes type 2. Also, I had severe muscle and joint pains off and on for many months after taking Lipitor. I eventually stopped taking Lipitor because of the pain, and have tried other statins since then (simvastatin, pravastatin, Crestor), which eventually always caused me joint and/or muscle pain. My worst pain was in my ankles, which made it difficult to walk or to climb stairs. I suspect this to be caused by the combination of having diabetes and taking statin medication. However, I stopped taking statins altogether last fall, 2011, and have gradually been feeling less and less pain. I really had a hard time getting through the winter of 2010, while I was still taking statin medications. But since I have stopped taking statins, I have much less pain this winter than last winter. Therefore, it is my opinion that statin medications caused my diabetes. I also believe that statins cause and/or aggravate excessive pain in muscles and joints, which destroys quality of life–at least in my case. I would rather have cholesterol in the 200s than sit at home crying with pain, and not able to walk or go anywhere, etc.

    Posted by Antoinette Snyder |
  8. Can you comment on how Red Yeast Rice may be used instead of statins? I’ve read about it but wondered if maybe its a better idea to take that than statins. Thank you.

    Posted by Kim |
  9. I have read many reports that while statins reduce LDL cholesterol it’s never been proven that high LDL cholesterol causes heart attacks or stroke. But people have been making and repeating this supposed positive association so long that we have now taken it as true. It’s also unnerving to think statins are the most widely prescribed drug when it’s only been shown that their benefit is for those who have already had a heart attack.

    Posted by Riva |
  10. I’m saddened and angered by Becky, Linda, Antoinette, and Vicki’s experiences with statins. The problem is that, when considering a drug or surgical therapy, the medical profession only considers the potential benefits. They don’t look at the side effects and adverse reactions that can really mess up people’s lives. If you subtracted the negatives from the benefits, you wouldn’t be left with much. Except maybe, as Riva says, for people who have already had heart attacks AND have high cholesterol.

    From what I’ve seen, perhaps women should not take statins at all, unless they are very high risk for heart attacks/strokes. Men may be different. They seem to have fewer problems with them.

    Kim, I don’t know anything about red yeast rice. I’ll look into it.

    Posted by David Spero RN |
  11. Red yeast rice,suppose to have similar ingredients to statins.I heard that the FDA does not allow to sell it that way;thus this ingredient is taken out .I took red yeast rice;it did not work for me .Of course who knows what was in it.Remember supplements (over the counter) medications are not regulated by the FDA.

    Posted by Ludovico Croati |
  12. The only way I can keep my cholesterol down is by taking statins. I am diabetic but don’t blame it on statins. I have had to go off from some statins and my cholesterol went over 200 in a short time and not from what I ate. I will stay on statins and keep my cholesterol at a healthy number.

    Posted by Ferne |
  13. I think if statins could be reason of diabetes then womens must avoid its intake.

    Posted by parker bin |
  14. I’ve been diabetic and have taken Lipitor for many years now with good results and no side effects. I was switched to generic version of Lipitor and within two months developed terrible leg pain. After finally realizing what was causing this, I stopped the Lipitor. Cholesterol went up aain, but I began more drastic diabetic maintenance (only vegetable and fruit carbs) and diabetic response is great. Now I’m reading how cholesterol medicines are really not good for you (beyond purpose of lowering cholesterol) and I wonder why HO DOCTOR EVER told me it redauced CoQ10 enzyme that needed to be replaced with supplements (did that cause the leg pain?). It’s very confusing but I’m working on trying natural ways to reduce cholesterol for now, wish me luck with next blood test.

    Posted by janice |
  15. Briefly: I have Type 2 Diabetes and am 68 y/o. My doctor hounds me about taking statins due to my higher LDL than HDL and total cholesterol of 225. I paid for a Heart Scan (which is not paid by Medicare but is less than $100),which detects Calcium in arteries @ my local hospital. The results showed NO calcium in ANY of the heart arteries and that I had less than 5% chance of developing CVD. My doctor didn’t act impressed and still pushes me on statins. He’s thrown every statin at me and all of them had bad side effects: dizziness, muscle pain, nausea and bloating. I remain suspicious that the drug companies have lowered the threshold and now even more people “qualify” for statins to lower cholesterol to reach their numbers. I have the same suspicions about Glucose numbers, too.

    What does one do? Both parents had a form of heart disease, but they lived to be 85 (Dad) and 99 (Mom)-on a good diet and exercise and without statins.

    Posted by Kay |
  16. Hello everyone,
    I just finished reading a very interesting book on cholesterol…definitely a ‘Must Read’ for anyone contemplating or currently taking statins. It’s called “The Great Cholesterol Con” by Dr. Malcolm Kendrick. It’s amazing how the results of research studies can be so misconstrued to appear safe instead of ineffective at best.

    Posted by Gail |
  17. I’ve been on statins (first Zocor, now Lipitor) for about 6 or 7 years after my total cholesterol crept over 200, with associated high triglycerides. Of course my numbers improved once I was taking the first long term medication of my life. Three years ago, after many years of being warned that I could possibly be pre-diabetic, my blood glucose level went over the 120 threshhold with an A1C of close to 10.0. Welcome to Type II Diabetes Jerry! Now with the magic of more oral medication, good diet and exercise, my Diabetes is under control. I read an article today referring to the statin - diabetes connection, and got online to see what else had been written, thus I ended up here. I had thought it was just a natural progression that brought me to this point, BUT I have also wondered why there has been such an explosion of high cholesterol and diabetes diagnoses in the past few years. Yes the obesity problem is HUGE (pun???) but it seems that drug companies reap BIG profits as more people are diagnosed and enslaved to their products. Lower the magic numbers that trigger the diagnosis, and bingo…. more diagnoses! Hmmmmmm………

    Posted by Jerry T. |
  18. I am very concerned about what i have read here. I am 60 years old, have an AC1 of 7. Just receieved the Type 2 diagnosis about one minth ago. I weighed 178 (5′3″) but in this month, due to a diet with good healthy choices, i have dropped to 171. My chloresterol is 241 with LDL of 156, but i am hoping with my change in eating habits this will change. Neither of my parents had heart disease nor diabetes, so there is no history there.
    At my first diabetic diagnosis visit, my doctor insisted i had to be on a statin drug.
    He prescribed a low dose of lipitor - generic.
    I have filled it and began one pill .
    Now, i am questioning the validity of this.
    As he put it, if something SHOULD happen, he would know that he did the right preventive measures.

    Betty

    Posted by Betty W |
  19. I was diagnosed with Type II diabetes in 202 and have kept my A1C between 5.7 and 6.3 ever since. My HDL is 51 and my LDL 135, triglycerides 100. I am obese (though I have lost 70 pounds and counting) and my blood pressure is generally between 120/80 and 135/88. I exercise 3-4 times a week for 30-60 minutes. Still every dr. I see insists I take statins. When I object, they bully me with “Do you want to have a heart attack?” I let them write the prescription but I just won’t take it. Oh, and I have moderate liver damage from Hep C (supposedly gone with interferon treatments 8 years ago). Any comments? Is there any doctor out there who doesn’t immediately resort to statins when they hear the word “diabetes”? I have to think there is a difference between patients with controlled diabetes and those with uncontrolled.

    Frustrated 58-year old female

    Posted by Debbi |
  20. Oops, 2002

    Posted by Debbi |

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