Statins and Glucose Levels
Could statins cause diabetes or high blood sugar levels? This is a major question. Many of you have probably heard about the studies suggesting a higher risk of diabetes when taking statins. This data from Women’s Health Initiative (WHI) hints that the risk of new onset diabetes is higher than suggested by previous studies. The investigators have reported a 48% increased risk of diabetes among the postmenopausal women aged 50-79 years old who take the lipid-lowering medications.
A meta-analysis published in the Lancet in 2010 also showed that statin therapy was associated with a 9% increased risk of diabetes.
A significantly increased risk of diabetes was observed in White, Hispanic, and Asian women. Among African- Americans, who made up 8.3% of the population studied, there was an insignificant 18% increased diabetes risk associated with statin use at baseline.
Should you stop taking statins?
What are the important points that we should learn after reading these studies? Is there any reason of changing our approach to treating high cholesterol with this group of medications?
Before concluding or thinking about any changes in our view to statins we should realize the following points,
First that statins are one of the most important groups of medications in the history of medicine. In multiple well designed studies, it has been clearly shown that statins have the ability reducing cardiovascular events in a significant way.
We also know that heart disease is the number one killer in our society year after year.
Second that the higher risk for high glucose level and diabetes has been seen in older patients and mostly dosage related. It means those patients who have been on more intensive dosage had higher chance of getting diabetes than others on lower dosage.
But at the same time, the same patients on intensive and higher dosage of statins were better protected against heart disease compared to others on lower dosage.
Third of all we should know that patients on statins are mostly higher risk patients. This is an important issue because we do not know retrospectively how many of these patients would end up with high glucose level or diabetes anyways, if they were not on this medication.
Benefits of Statins Outweigh Diabetes Risks
I am thankful for these kinds of studies because it confirms that nothing in our life can function in an extreme way. In my position, as a Lipidologist, I have seen increased unrefined usage of statins without considering the risk factors of a patient or recognizing the interactions between this group and other medications of the patients in countless cases.
The notion that statins can be put in the public water so everybody is able to enjoy its benefits should be questioned.
We as human beings have learned to use automobile despite its many dangers and problems. Using medication in the right and measured way is also not very different.
In my opinion, the risks and benefits of the treatment for each patient should be thoroughly examined and the complexity of high cholesterol management should be appreciated.
This continuous challenge of finding the right balance between risks and benefits with the purpose of delivering the highest value to each individual patient make our task as physicians and patients rewarding and in the same time unique.
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