I just heard this this morning - that statin drug use is linked to an increased risk of diabetes in women. I understand that the decreased risk in heart disease is greater than the increased risk in developing diabetes. I imagine we will be geting lots of questions about this. All the news is playing down the increased risk, but I hope patients and providers will use this information in an individualized risk - benefit assessment. Just wondering what you are telling your patients who ask about this news.

This reminds me of the studies of niacin use for diabetics.  The early studies were done by the infamous Scott Grundy. His first study in 1990 indicated that niacin markedly raised blood sugars for diabetics and it was concluded that it was inappropriate for diabetics.  But that never stopped Grundy.  He redid the study in 2002 and although he had somewhat of a disaster of results, he reversed his conclusion and declared it safe for diabetics.

Here is what he found in his second study. In a controlled study, diabetics were given either no niacin, a 1000 mg/day or 1500 mg/day. Doctors were told to increase medication if needed to control blood sugar. Despite increased medication, the HbA1c of the diabetics degraded in a statistically significant and proportional way. Apparently some of the patients had to go on insulin during the trial. And this study concluded that the medication was safe for diabetics. Why?  Apparently because any cholesterol improvement was by far more important than the loss of blood sugar control.

As long as nobody dies from high cholesterol the results must be good.

ps. My diabetes originally went out of control after starting statins.  I've always wondered if there was a relationship.

What to tell patients with diabetes re: this new statin info??

Here it is:

Statistically, 66% of diabetes patients wil die from cardiovascular or coronary heart disease.

Mary Ann Hodorowicz, RD, CDE, MBA, Certified Endocrinology Coder
PresentDiabetes Author of MNT and DSMT Reimbursement Audio Lectures

Eat Well, Laugh Often, Love Much

The Lancet looked at this as well, although older data, there is more of it in comparison to just one study.
My only other comment: most of the patients that I see haven't incorporated healthy eating and increasing physical activity(ok, many don't do anything)  to help lower their risk, so I always say: let's start with that first.  (Not rocket science....)!

doi:10.1016/S0140-6736(09)61965-6Cite or Link Using DOI

And repeated studies of cholesterol lowering has not been found to statistically reduce the rates of CVD or mortaility.  The fact that diabetics are at higher risk of CVD is true, but the science behind statins and cholesterol lowering is weak.

A patient just asked me about this yesterday.  She has an A1C that has been rising slowly over the last year to 6.7%.  She has been on a statin for years but was just switched from one kind to another within the last year and is concerned that the slow rise in A1C over the past year may be a result of that switch.  I told her she had a valid point and to discuss it with her doctor (appointment next week) but to continue taking the statin until she talks to her doctor.  

I also talked to the PharmD here who said that for people who already have diabetes the risks of taking the statin do not outweigh the benefit at this point.  But for a patient who is not diagnosed or newly diagnosed (like the one above) it is something to consider and a different cholesterol lowering drug may be in order.  

Interesing. Thanks for sharing Micki.