What Links Statins to Type 2?
There has been news that statins contribute to diabetes in women. As a woman who has taken statins and been diagnosed with type 2 diabetes (I have no family history nor do I meet the usual profile of a type 2 diagnosis), I would like to know more about this link. Betsey R. Rosenbaum, Alexandria, Virginia
Craig Williams, PharmD, responds:
Every drug has risks and benefits, and the decision of whether or not to use a drug depends on the balance of those factors in a patient.
What to Know
The leading cause of death in people with diabetes is heart disease. The most effective therapy to lower the long-term risk of atherosclerotic heart disease (disease that starts in the arteries) is a statin. Statins reduce risk mostly by lowering LDL (“bad”) cholesterol. Several years ago, a very large study of a statin was done in patients at high risk for developing type 2 diabetes. That trial found a small but significant increased risk of being diagnosed with diabetes in the group on the statin compared with the group on placebo (a sugar pill). The incidence was 3 percent in the statin group and 2.4 percent in the placebo group.
This prompted other researchers to go back through studies of other statins, and it turned out that the finding was consistent across different statin drugs. As far as we can tell from the data, women are at no more risk of developing statin-associated diabetes than men. The risk was greatest among people with risk factors for type 2 diabetes (higher body weight, more sedentary lifestyle, high triglycerides). But the same reanalyses of these trials also confirmed the overwhelming benefit of statins for the heart. This benefit is actually even greater in patients with diabetes or at risk for diabetes compared with other patients. In the final analysis, for every one new case of diabetes that was diagnosed in the statin group, the statin prevented five new cases of heart disease.
Find Out More
While there is a small increased risk of developing elevated blood sugar on a statin, the risk is primarily in people already at risk for developing diabetes. The benefit of the statin for the heart far outweighs these risks.