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Statins and Diabetes
March 7, 2012
Statins, the group of cholesterol-lowering drugs that includes atorvastatin (brand name Lipitor), simvastatin (Zocor), and rosuvastatin (Crestor), have been under increased scrutiny during the last couple of years as studies have linked them to an elevated risk of Type 2 diabetes. Most recently, as David Spero noted in a January blog post here at DiabetesSelfManagement.com, a study of statins in postmenopausal women found a 48% higher risk of diabetes among women who took one of these drugs compared with those who did not. Since this was not a randomized clinical trial, its results are not conclusive. But enough studies have raised concerns that last week, as a New York Times opinion piece notes, the US Food and Drug Administration (FDA) added a warning on diabetes risk to the label of all statins.
As the Times piece explains, statins are the most widely prescribed drugs in the world, and they have been in use since the 1980’s. But more powerful statins have achieved widespread use only in the last decade or so, and it appears that these drugs are associated with the greatest diabetes risk. With 20 million Americans taking statins and an estimated risk of developing diabetes from the drugs of 1 in 200, 100,000 people could have diabetes as a result of these drugs. Furthermore, the piece notes, among people without existing heart disease who take statins, the drugs prevent only one heart attack or stroke for every 50 people taking them.
Although it is clear from those numbers that statins provide no overwhelming heart-risk reduction or diabetes-risk increase to most people who take them, it is also clear that the heart-related benefit from these drugs is statistically greater than their diabetes-related risk. One particular study, published last year in the Journal of the American Medical Association, found even less of a heart benefit or diabetes risk from taking intensive doses of statins. Each year, according to the study, one “cardiovascular event” is prevented for every 155 people taking high doses of statins, while a new case of statin-induced diabetes occurs among every 498 people taking the drugs.
Of course, comparing the suffering or inconvenience caused by a heart attack or a stroke with that of diabetes is nearly impossible. According to a study published last year in the European Heart Journal, however, using statins leads to an overall lower death rate — mostly, among participants in this study, from a reduction in infections and respiratory disease. While statins have been found in the past to reduce inflammation — one possible reason for their benefits — the mechanism through which they do this, or through which they cause diabetes, is unknown.
What do you think — if you currently take a statin, are you concerned that it might have a negative effect on your diabetes? Or are you more concerned about preventing a heart attack or stroke? Do you think statins may have played a role in causing your diabetes? Has taking a statin led, in your estimation, to any increase or decrease in your quality of life? Are you, or would you be, comfortable taking a drug whose benefits may be partly — or even mostly — unrelated to the reason for which it was prescribed? Leave a comment below!
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