STATINS AND DIABETES

Posted on August 12, 2012. Filed under: Uncategorized | Tags: , , |

Statin cholesterol-lowering drugs reduce risk for heart attack and premature death from cardiovascular disease but have significant risks. In 1975 our research showed how dramatically diet could reduce serum cholesterol (down 35%) and LDL (bad-guy cholesterol by 40%)(1). In 2003, editors of the Journal of the American Medical Association asked me to write an editorial about the side effects of statin drugs (2). Since then I have closely followed the mounting evidence related to the side effects of statin drugs. Now we should add diabetes to this list of risks or side effects.

In mid-August 2012 another study confirms that taking statins increases risk for diabetes (3) as well as risk for dementia and neurological diseases. These are common side effects of statins: stomach irritation; one in ten get muscle aching and some get severe muscle damage (4) or damage to tendons (5); and neuropathy (tingling or pain in legs) or damage to the nerves (6). Serious concerns related to statin use are these: more rapid loss of cognition with aging (7;8); occasional cases of serious neurological conditions such as Lou Gehrig’s disease (9;10).

Most people can lower their LDL (bad-guy) cholesterol by 33% through diet (including soluble fiber like oats and soy protein) and using supplements such as psyllium and plant sterols. For most adults, an LDL less than 130 mg/dl is desirable and less than 100 mg/dl is ideal. If someone has high risk for heart attack, their value should be 70-100 mg/dl. If you have heart disease of history of stroke—and you are less than 70 years old– your LDL should be in the 50-70 mg/dl range. Since statins accelerate loss of cognition for persons over 70 years, you should have your LDL in the 70-100 mg/dl range, no matter what your heart attack risk is. Details of my research on statins and LDL-cholesterol and that of others are provided on other Nutdoc posts. Best, Nutdoc

   1.   Kiehm TG, Anderson JW, Ward K. Beneficial effects of a high carbohydrate, high fiber diet on hyperglycemic diabetic men. Am J Clin Nutr 1976;29:895-9.

2.   Anderson JW. Diet first, then medication for hypercholesterolemia. JAMA 2003;290:531-3.

3.   Ridker PM, Pradhan A, MacFayden JG, Libby P, Glynn RJ. Cardiovascular benefits and diabetes risks of statin therapy in primary prevention: an analysis of the JUPITER trial. Lancet 2012;380:565-71.

4.   Joy TR, Hegele RA. Narrative review: statin-related myopathy. Ann Intern Med 2009;150:858-68.

5.   Marie I, Delafenetre H, Massy N, Thuillez C, Noblet C. Tendinous disorders attributed to statins: a study on ninety-six spontaneous reports in the period 1990-2005 and review of the literature. Arthritis Rheum 2008;59:367-72.

6.   de Langen JJ, van Puijenbroek EP. HMG-CoA-reductase inhibitors and neuropathy: reports to the Netherlands Pharmacovigilance Centre. Neth J Med 2006;64:334-8.

7.   Xiong GL, Benson A, Doraiswamy PM. Statins and cognition: what can we learn from existing randomized trials? CNS Spectr 2005;10:867-74.

8.   Elias PK, Elias MF, D’Agostino RB, Sullivan LM, Wolf PA. Serum cholesterol and cognitive performance in the Framingham Heart Study. Psychosom Med 2005;67:24-30.

9.   Cramer C, Haan MN, Galea S, Langa KM, Kalbfleisch JD. Use of statins and incidence of dementia and cognitive impairment without dementia in a cohort study. Neurology 2008;71:344-50.

10.   Edwards IR, Star K, Kiuru A. Statins, neuromuscular degenerative disease and an amyotrophic lateral sclerosis-like syndrome: an analysis of individual case safety reports from vigibase. Drug Saf 2007;30:515-25.

 

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