Statins: How the drug prevents heart attacks and strokes

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High cholesterol means you have too much of a fatty substance called cholesterol in your body. This is a major precursor to heart disease but it is not the only precursor. Diabetes, which millions of people live with in the UK, also raises your risk of heart problems. In fact, people with diabetes often have high cholesterol too because they are both linked to poor lifestyle decisions. As a result, people with diabetes may take statins, which reduce the levels of cholesterol in the blood.

However, a new study by JAMA Internal Medicine suggests the combination of statin therapy and diabetes may in fact worsen the latter’s symptoms.

Researchers found a strong association between those taking the cholesterol-lowering drugs and worsening diabetes symptoms when compared to those not on statins.

Statin users had a 37 percent higher risk for diabetes progression, including extremely high blood sugar levels and elevated rates of disease complications, compared with those not on the prescription drugs, the data showed.

The link to spiralling blood sugar levels is of particular concern because high blood sugar is the main driver of diabetes complications.

In the study, 56 percent of statin users showed signs of diabetes progression and needed to be started on insulin treatment and other blood sugar-lowering therapies, compared with 48 percent of those not on the drugs.

“Association does not prove causation, [so] no patient should stop taking their statins based on our study,” co-author Dr. Ishak Mansi told health website UPI in an email.

However, “patients on statins may need to escalate their anti-diabetes therapy when they initiate treatment”, said Mansi, a professor of medicine and data and population science at the University of Texas Southwestern in Dallas.

Adjusting medications – either changing doses or drugs – is a common practice in the management of diabetes, anyway, he noted.

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How did the researchers arrive at this conclusion?

To gather their findings, the researchers compared rates of diabetes progression among more than 83,000 adults with Type 2 diabetes on statin therapy with those within a similar population not on the drugs.

All of the study participants were being treated in the Veterans’ Affairs health system, (VHA) the researchers said.

VHA is the largest integrated health care system in the United States.

Study participants were considered to have diabetes progression if they needed to start treatments to maintain healthy insulin levels – the hormone produced by the pancreas that processes sugars – or other blood-glucose-lowering therapies.

Those who developed diabetes related complications such as ketoacidosis, whereby the body produces elevated amounts of blood acids, which can lead to severe dehydration, and hyperglycaemia, or dangerously high blood sugar levels, also were defined as having diabetes progression.

Statins side effects

It is worth noting that many people who take statins experience no or very few side effects.

The risks of any side effects also have to be balanced against the benefits of preventing serious problems.

A review of scientific studies into the effectiveness of statins found around one in every 50 people who take the medicine for five years will avoid a serious event, such as a heart attack or stroke, as a result.

“Your doctor should discuss the risks and benefits of taking statins if they’re offered to you,” advises the NHS.

The health body continues: “If you find certain side effects particularly troublesome, talk to the doctor in charge of your care.

“Your dose may need to be adjusted or you may need a different type of statin.”

Common side effects include:

• Headache
• Dizziness
• Feeling sick
• Feeling unusually tired or physically weak
• Digestive system problems, such as constipation, diarrhoea, indigestion or farting
• Muscle pain
• Sleep problems
• Low blood platelet count.

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