More about statin side effects

February 2012

Diabetics – don´t eat statins!

It is well established that patients with diabetes run a greater risk of developing cardiovascular diseases. In Sweden and in most other countries cholesterol-lowering treatment is therefore prescribed routinely to all diabetics, whether their cholesterol is high or low and failure to do so is seen as professional misconduct. But there are a number of observations that should have stopped this habit long ago.

First, at least fourteen studies have shown that high cholesterol is not a risk factor for patients with diabetes. If you are in doubt, go to chapter 4 in my book “Ignore the Awkward!, there you will find the references to these studies. The reason is probably the fact that high cholesterol may protect against infections, a common problem for diabetic patients. As readers of my books know, there is strong evidence that the lipoproteins are able to bind and inactivate all kinds of bacteria and virus. You can read more about that in a paper that I have published together with Kilmer McCully.

A critical and well-informed reader may possibly say that the small effect from statin treatment is not due to cholesterol lowering, but to their other effects, and this is true. If so, statin treatment perhaps may benefit a diabetic in other ways. But here comes the next warning: Statin treatment may cause diabetes!

Several of the statin trials ended up with more diabetics in the treatment group. For instance, in the JUPITER trial 3 per cent got diabetes, but only 2.4 per cent among the untreated control individuals.

The authors wrote that this small risk was more than balanced by the benefits. Then what was the benefit?

In the control group 2,7 % died, in the treatment group only 2.2 %!

The trial was stopped already after less than two years because of the good results. The question is, how many would have gotten diabetes after ten years? Let us take a look at a recent report from a study called Womens Health Initiative

More than 150,000 US women age 50-79 were followed for 7-12 years. At follow-up about ten per cent of the women were on statin treatment. Almost ten per cent of the statin-treated women had diabetes, but only six per cent among the non-users. And please recall that no statin trial has ever succeeded in lowering mortality for women.

There is a logical reason why cholesterol lowering may lead to diabetes. Like all other organs and structures, the insulin-producing cells need cholesterol, and when less cholesterol is available, less insulin is produced. This was recently demonstrated by a group of researchers from Toronto

What happens with those who already have diabetes when they start statin treatment? We don’t know because nobody has analysed this question.

Is it really wise to treat diabetic patients with a drug that worsen the function of their insulin-producing cells? And is it wise to lower the risk of cardiovascular diseases in other people with a treatment that may cause a disease, which increases the risk? Or, as you know from my December 2011vnewsletter, may result in cancer in the long run, not to mention the risk of the many other unpleasant side effects.