Diabetes and Statins – Health Risks

Diabetes and Statins - Health RisksI am not great fan of statins after years of experience and research – I believe they are significantly overused and at far too high a dose in many, many people.  However, this post is not about statins in general but specifically about statins if you have diabetes or you are at risk of diabetes.

For some time it has been known that taking statins increases your risk of developing type2 diabetes – the amount of risk is not that easy to calculate because many studies of statins did not continue for long enough to be really certain how many increased cases of diabetes occur.

However a new large population base study(1)has told us two things –

  1. The increased risk is greater than was previously thought.
  2. The risk is dose related – the higher the dose the higher the risk.

It was previously believed that the increased risk was in the region of 10-22% extra cases but this study indicates statin therapy appears to increase the risk for type 2 diabetes by 46%. It looked at nearly 9,000 men over 6 years but unlike other studies where diabetes was identified by self-reporting this study actively screened the men for diabetes.

In other words if you take a statin you approximately double your risk of developing diabetes.

The study also looked at why taking statins caused increased diabetes and identified two mechanisms-

  1. Statins increase insulin resistance- by about 25%
  2. Statins reduce insulin secretion by the pancreas by about 12%

This is a double whammy – less response to insulin and worsening ability to produce insulin.

So… what should you do if you have diabetes and are taking a statin or even at high risk of diabetes and take a statin? It probably depends on why you are taking them and you should certainly consult with your health care professional about this.

Here are some pointers to what you should consider discussing, depending on whether you have had a heart attack/stroke or not ….

If you have never had heart disease or a stroke i.e. you are taking statins for what is known as “primary” prevention –

You should know that the balance of evidence indicates that life expectancy is not increased at all for taking a statin.

If you take a statin for FIVE years then outcomes can be summarised as follows –

  • Lives saved – None were helped
  • Preventing heart attack – 1 in 104 were helped
  • Preventing stroke – 1 in 154 were helped
  • Develop diabetes – 1 in 25-50 were harmed
  • Muscle damage – 1 in 4 were harmed

If you have already had heart disease or a stroke i.e. you are taking statins for what is known as “secondary ” prevention –

  • Lives saved – 1 in 83 were helped
  • Preventing non-fatal heart attack – 1 in 104 were helped
  • Preventing stroke – 1 in 125 were helped

(The harms are obviously the same as above.)

So maybe we can genuinely say that if you already have heart disease then overall statins appear to be helpful (if you are a man at least – the evidence of benefit it is less clear cut in women).

HOWEVER, you might want to consider two important things…

FIRSTLY what do we mean by lives saved?

In the Heart Protection Study treating 10,000 at high risk who had established heart disease then the results were trumpeted as follows – “If now, an extra 10 million high-risk people worldwide go onto statin treatment, this would save about 50,000 lives each year – that’s a thousand a week”

Whilst “technically” correct the study actually found that after five years –

  • 92.6% of those in the statin arm were still alive,

  • 90.8% of those in the placebo arm were still alive.

A difference of 1.8%

AND

For those 1.8% whose lives were “saved” they lived on average an extra 6 months.

SECONDLY the risk of diabetes is dose related 

The higher the dose of statin the higher the risk.

The benefit of statins, where it exists at all, appears to be unrelated to lowering cholesterol but due to lowering inflammation and this benefit occurs at low doses – so no need to use high doses to achieve it with all the associated increased risks.

So there you have it…

In reality, my observation is that nearly everyone with diabetes or considered high risk of diabetes is automatically considered high risk of heart disease and it therefore almost invariably advised to take a statin.

As I have said already, you should discuss this with your health professional and it is not my place to tell you as an individual what you should or should not do- indeed each person will have different actual risk which may be hard to assess.

BUT I do passionately believe you should be informed and aware and not simply blindly accept treatment without a good understanding of whether it is right for you.

Take care of you!

Dr David Morris

Family Practitioner and Integrative Medicine Physician

Ref

1.http://www.ncbi.nlm.nih.gov/pubmed/25754552

For those wishing to arm themselves with further knowledge here are two links to explore:

If you want to know more around statins in general I would wholeheartedly recommend you read Dr Malcolm Kendrick’s, “The Great Cholesterol Con”

and for a dispassionate analysis of the risk and benefits explore:

http://www.thennt.com/nnt/statins-for-heart-disease-prevention-without-prior-heart-disease/

Enjoy!

If you found this article interesting, thought provoking or just plain wrong, please leave a comment and share on your social media of choice.  Thanks

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