Taking Statins Linked to Greater Diabetes Progression

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Taking Statins Linked to Greater Diabetes Progression

Taking a statin — the widely prescribed family of drugs used to reduce blood lipid (cholesterol and triglyceride) levels — is linked to greater diabetes progression, according to a new study published in the journal JAMA Internal Medicine.

Previous studies have shown that using statins is linked to insulin resistance — a hallmark of type 2 diabetes in which cells become less sensitive to the effects of insulin, which typically begins before glucose levels start to rise. But there hasn’t been much research linking statin use to higher blood glucose levels in people with established diabetes. For the latest study, researchers were interested in comparing the course of diabetes between people who used statins and otherwise similar people who didn’t.

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The study’s participants consisted of 83,022 pairs of participants with diabetes, matched based on diabetes severity and factors that might lead to diabetes progression. One person in each pair started using a statin between 2003 and 2015, while the other person started using an H2-blocker or proton pump inhibitor — drugs used to treat acid reflux — during the same period and were not prescribed a statin. The average age of participants was 60.1, and about 95% were men — a consequence of them being recruited from Veterans Affairs health system patients, as noted in a Healio article on the study.

Diabetes progression was measured by looking at a combination of factors including starting to take insulin, significantly elevated blood glucose levels, acute complications of high blood glucose (such as diabetic ketoacidosis), and an increased number of prescriptions for glucose-lowering drugs. During the study period, diabetes progression occurred in 55.9% of statin users, and in 48.0% of non-statin users. This translated into a 37% higher overall rate of diabetes progression among statin users compared with their matched partners in the study. A detailed analysis of the data showed that there was a dose-dependent relationship between the reduction in LDL (low-density lipoprotein, or “bad”) cholesterol that participants in the statin group experienced, and the amount of diabetes progression.

This last finding — that greater LDL cholesterol reduction goes hand-in-hand with greater diabetes progression — suggests that taking statins may be directly responsible for the higher risk of diabetes progression seen in the study. It also suggests that at least for patients with diabetes, doctors face a trade-off when evaluating treatment options for high cholesterol or triglycerides. Aggressively reducing cholesterol or triglycerides may reduce the risk for cardiovascular problems, while at the same time worsening blood glucose control and increasing the risk for diabetes complications.

“The risk-benefit ratio of statin use in patients with diabetes should take into consideration its metabolic affects,” the researchers concluded. More research is needed to look at how this risk profile may vary in different people with diabetes based on their blood glucose control, cardiovascular risk factors, and other factors.

Want to learn more about maintaining healthy cholesterol levels? Read “Natural Ways to Lower Your Cholesterol,” “Statin Alternatives: Other Medications That Can Lower Cholesterol,” “Your Cholesterol Questions Answered,” and “HDL: Nine Ways to Lower Your Cholesterol.” 

Quinn Phillips

Quinn Phillips

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A freelance health writer and editor based in Wisconsin, Phillips has a degree from Harvard University. He is a former Editorial Assistant for Diabetes Self-Management and has years of experience covering diabetes and related health conditions. Phillips writes on a variety of topics, but is especially interested in the intersection of health and public policy.

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