Now there's some more evidence that taking cholesterol-lowering drugs can raise the risk for diabetes. But doctors say the small increase seen doesn't mean people at risk for serious heart trouble should stop taking the medicines.
An analysis in the latest issue of JAMA took a look at five previously published studies that included more than 32,000 people who were treated with high and moderate doses of statins, medicine used to control cholesterol and prevent heart disease.
People taking high doses of the statins were more likely to develop diabetes than those taking the moderate doses of the drugs. The increase for those taking the high doses amounted to 2 additional cases of diabetes per 1,000 patients compared with those on lower doses.
The finding that risk increased with dose bolsters the case for a diabetes link. A previous analysis suggesting a diabetes-statin association was published in the medical journal Lancet last year.
Still, the increased risk for diabetes observed in the latest analysis was overshadowed by the cardiovascular benefits of the drugs. To see a new case of diabetes, 498 people would need to be treated with a high dose of statins for a year. To prevent one serious cardiovascular problem, such as a heart attack or stroke, just 155 people would need to be treated with high-dose statins for a year.
The medicines used in the studies were Lipitor (atorvastatin, generically), Zocor (simvastatin) and Pravachol (pravastatin). Statins have been the go-to drug for lowering cholesterol and preventing heart disease for more than two decades.
Bottom line: the benefits of statin therapy for patients at risk for heart disease and strokes outweigh the risks. "Statins are the best therapy we have for cardiovascular disease," Harvard cardiologist Christopher P. Cannon told Shots. "It's useful to be aware that this is an issue" said Cannon, who is also one of the study's authors.
Cannon said it's unlikely that doctors will change the way they treat their patients as a result of the finding. Still, the researchers suggest that doctors be vigilant when treating people with high doses of statin, particularly for the long-term.
Even so, Dr. Paul Jellinger, a diabetes specialist in Florida, told Shots, the finding is "trivial in terms of incidence of diabetes." He cautioned patients who might consider stopping statins not to. "I won't hesitate to use statins in patients with diabetes or prediabetes," he said. "I'm not going to worry about mild sugar levels when I can reduce" the levels of bad cholesterol.
Baylor medical school endocrinologist Alan Garber offered this context to Shots:
People are disappointed when they find out that their medications are not risk-free. Nothing we do is risk-free.