New research from Denmark has raised the possibility that taking the cholesterol-lowering medicines known as statins may reduce the risk of microvascular diabetes complications, or those involving the small blood vessels. Approximately 36 million Americans are currently prescribed statins, a drug class that includes atorvastatin (brand name Lipitor), fluvastatin (Lescol), lovastatin (Altoprev, Mevacor), pitavastatin (Livalo), pravastatin (Pravachol), rosuvastatin (Crestor), and simvastatin (Zocor).
It is well established that statins decrease the risk of macrovascular diabetes complications, or those involving the large blood vessels, such as heart attack and stroke. The medicines have, however, been linked with slight increases in blood glucose levels, and damage to the small blood vessels from chronically high blood glucose is what causes microvascular diabetes complications such as neuropathy (nerve damage), retinopathy (eye damage), and nephropathy (kidney damage).
To evaluate whether having taken statins prior to a diabetes diagnosis increases a person’s risk of developing microvascular complications, researchers from Herlev Hospital and Copenhagen University Hospital in Denmark looked at data from over 60,000 people age 40 or older with diabetes: 15,679 users of statins and 47,037 nonusers of statins. The follow-up period ranged from 0 to 13 years, with a median (midpoint) of 2.7 years.
As in other studies, those taking statins were found to have a slightly increased risk of being diagnosed with diabetes. Having been diagnosed, however, statin users were 34% less likely to develop diabetic neuropathy, 40% less likely to develop diabetic retinopathy, and 12% less likely to develop gangrene of the foot. The risk of diabetic nephropathy was similar between the two groups.
In linked commentary, David Preiss, MD, PhD, suggested that the microvascular benefits from statins, if any, might be due to their anti-inflammatory effects, rather than their cholesterol-lowering effects.
“This just reaffirms that statins work through multiple complex mechanisms, and that it is important to do the study rather than to come to conclusions based on assumptions,” stated Allison B. Reiss, MD, who was not involved in the research.
The investigators note that further study is needed to determine whether statins can protect against certain microvascular complications, as their research suggests. The results might be different in a more diverse population, adds Reiss.
For more information, read the article “Diabetes: Statins May Reduce Microvascular Risk” or see the study’s abstract in the journal The Lancet Diabetes & Endocrinology. And to learn more about diabetes complications, click here.