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High-Dose Statins May Increase Diabetes Risk

Experts Say Most Heart Disease Patients Are Better Off Taking a Statin, Despite Increased Diabetes Risk

High-Dose Statins and Diabetes continued...

There was no difference in diabetes risk between types of statins; only dose seemed to matter.

Patients on the high-dose regimens saw their odds of diabetes rise about 12%, while their odds of having a cardiac event dropped by about 16%, compared to patients on more moderate statin doses.

“It’s a good study,” says Spyros Mezitis, MD, an endocrinologist at Lenox Hill Hospital in New York City, who was not involved in the research.

“There are more studies that need to be done to really home in on this,” he says. “But statins are being used very widely right now, so we need to know anything that happens with the statins.

“What a clinician like myself takes out of it is that for people who are on high-dose statins and haven’t been diagnosed with diabetes, we should be checking for diabetes,” he says.

Statins and Diabetes

Experts say they aren’t sure what the link may be between statins and diabetes.

Nissen points out that many of the lifestyle factors that lead to cardiovascular disease, like abdominal obesity and a sedentary lifestyle, also contribute to diabetes.

“Many of us think that all that’s happening here is that patients who likely are destined to develop diabetes may have that diagnosis made a little bit earlier if given statins,” he says.

Experts say, though, that they aren’t sure why statins may hasten that diagnosis.

One theory is that muscle soreness caused by statins may make people less likely to move around. Being sedentary, in turn, increases the risk of diabetes.

Studies in mice have shown that statins may interfere with the action of the hormone insulin in muscle cells.

Even with the increased risk of diabetes, most people with heart disease are still better off taking a statin, experts say.

What should change now, many say, is the conversation that doctors have with patients about these drugs and the doses at which they’re used.

“We’ve just kind of been putting people on it and perhaps not giving them the full information about the downside, even if the downside is not very big,” Preiss says.

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