What Statin Is Best For People With Diabetes?
If you have diabetes, you’re at a higher risk for heart disease and stroke. This makes it especially important to control other risk factors for cardiovascular problems, such as high cholesterol. Fortunately, there are medications called statins that are quite effective at lowering your low-density lipoprotein (LDL), or “bad” cholesterol. Which statin is most appropriate if you have diabetes? It depends on your overall cardiovascular risk, but the recommendations lean toward a moderate-intensity or high-intensity statin. There are several different types of statins. Some are more potent than others. They each work a little differently, but they all help lower cholesterol by interfering with a substance your body needs to make cholesterol in the liver. Statins have become some of the most widely prescribed medications in the world. They include atorvastatin (Lipitor), rosuvastatin (Crestor), as well as other generic and brand name versions. The optimal LDL level for most healthy people is between 70 and 100 mg/dL. If your LDL numbers exceed that range, your doctor should look at your overall heart disease and stroke risk to decide whether you should be placed on statins. Recent guidelines presented by the American College of Cardiology and the American Heart Association expanded the number of potential statin users. Doctors used to base their decision to prescribe a statin primarily on a person’s LDL score. Now, other risk factors are also considered. In general, statins are usually recommended for people who have: diagnosed cardiovascular disease an LDL cholesterol level of 190 mg/dL or higher diabetes and an LDL of 70 mg/dL or higher a 10-year heart attack risk of 7.5 percent or higher and an LDL of at least 100 mg/dL Statins and diabetes risk: What you need to Continue reading >>
If Statins Cause Diabetes, Why Should All Diabetics Take A Statin?
The guidelines from the American Heart Association and the American College of Cardiology are crystal clear. People with diabetes (both type-1 and type-2) should all be on a statin-type cholesterol-lowering medicine! There are no exceptions to this recommendation. Any physician who strays from the path of prescribing a statin to his or her diabetic patients will presumably be practicing bad medicine. What makes this guideline so intriguing is the growing body of evidence suggesting that statins cause diabetes in a substantial number of people. So, the very drug that induces elevated blood sugars is required to treat the cardiovascular risks associated with the development of drug-induced type-2 diabetes. Does this seem as odd to you as it does to us? Do Statins Cause Diabetes? Do you doubt that statins cause* diabetes? Here is just the latest research on this connection (Dormuth et al, BMJ, online, May 29, 2014). Researchers analyzed data on nearly 140,000 patients in Canada, the UK and the U.S. All the individuals had been hospitalized either because of a heart attack, stent placement or some other serious cardiovascular procedure. Some were given low-potency statins while others were placed on high-potency statins such as rosuvastatin (Crestor) at a dose of 10 mg or greater, atorvastatin (Lipitor) at a dose of 20 mg or higher or simvastatin (Zocor) at a dose of 40 mg or higher. None of the people in the analysis had been diagnosed or treated for diabetes prior to being placed on a statin. Within two years of starting on the medicine 3,629 patients were diagnosed with type-2 diabetes. Those given high-potency statins were 15% more likely to end up with blood sugar elevations compared to patients prescribed lower-potency statins or lower doses. The lead author, Colin Do Continue reading >>
Comparison Of Efficacy And Safety Of Rosuvastatin, Atorvastatin And Pravastatin Among Dyslipidemic Diabetic Patients
Comparison of Efficacy and Safety of Rosuvastatin, Atorvastatin and Pravastatin among Dyslipidemic Diabetic Patients 1Departments of Pharmacy and Clinical Pharmacy, Hamad General Hospital, Hamad Medical Corporation, P.O. Box 3050, Doha, Qatar 2Departments of Medicine and Endocrinology, Hamad Medical Corporation, P.O. Box 3050, Doha, Qatar 3Department of Medical Statistics and Epidemiology, Hamad Medical Corporation, P.O. Box 3050, Doha, Qatar 4Departments of Public Health and Medical Education, Weill Cornell Medical College in Qatar, P.O. Box 3050, Doha, Qatar 5Department of Evidence for Population Health Unit, School of Epidemiology and Health Sciences, The University of Manchester, Manchester, UK 6Pediatric Intensive Care Unit, Department of Pediatrics, Hamad Medical Corporation, P.O. Box 3050, Doha, Qatar Received 6 December 2012; Accepted 3 January 2013 Academic Editors: T.Kumai and T. B.Vree Copyright 2013 Lolwa Barakat et al. This is an open access article distributed under the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Objectives. To investigate the efficacy and the safety of the three most commonly prescribed statins (rosuvastatin, atorvastatin, and pravastatin) for managing dyslipidemia among diabetic patients in Qatar. Subjects and Methods. This retrospective observational population-based study included 350 consecutive diabetes patients who were diagnosed with dyslipidemia and prescribed any of the indicated statins between September 2005 and September 2009. Data was collected by review of the Pharmacy Database, the Electronic Medical Records Database (EMR viewer), and the Patient's Medical Records. Comparisons of lipid profile measurements Continue reading >>
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Rosuvastatin And Diabetes: When The Evidences Talk
Rosuvastatin and Diabetes: When the Evidences Talk Author(s): Vivencio Barrios , Carlos Escobar . Department of Cardiology, Hospital Ramon y Cajal, Ctra. Colmenar km 9.100, 28034 Madrid, Spain. Journal Name: Cardiovascular & Hematological Agents in Medicinal Chemistry Diabetes increases the risk of cardiovascular disease; however, this risk is further increased as a result of otherfactors. This observation is particularly relevant with regard to lipid abnormalities. Although diabetic dyslipidemia ischaracterized by hypertriglyceridemia, low HDL-cholesterol, and small dense LDL particles, the main determinant of therole of dyslipidemia in the prognosis of diabetics is LDL cholesterol. In recent years, LDL cholesterol targets havebecome progressively lower, and most current recommendations establish an LDL cholesterol target of <70 mg/dL fordiabetics. This target can only be achieved using potent statins at adequate doses. Although it has been suggested thatstatins may interfere with glycemic metabolism, the benefits of reducing LDL cholesterol by statins are much greater thanthis possible deleterious effect. Rosuvastatin is one of the most potent statins available. Several studies have shown that it effectively reduces LDLcholesterol to recommended targets in diabetics. Moreover, rosuvastatin modestly increases HDL cholesterol anddecreases triglycerides. The risk of side effects is low, as is the risk of interactions with other drugs. In this manuscript, the efficacy and safety profile of rosuvastatin in diabetic population is reviewed. Keywords: Diabetes, efficacy, HDL-cholesterol, LDL cholesterol, lipid profile, lipids, rosuvastatin, safety, statins, totalcholesterol, treatment, triglycerides. Cardiovascular & Hematological Agents in Medicinal Chemistry Title:Rosuvast Continue reading >>
Statin Use And Risk Of Diabetes Mellitus
Go to: STATINS IN DIABETES Statins are used for primary and secondary prevention of cardiovascular diseases. Other benefits due to statins are not mediated by their lipid lowering properties but due to its pleiotropic effects. In conditions like heart failure, cardiac arrhythmias, vascular disease and hypertension the non-lipid lowering pleotropic benefits of statins have been observed. These pleiotropic effects mediated by statins can be due to inhibition of isoprenoid synthesis which in turn inhibits intracellular signaling molecules Rho, Rac and Cdc42. The predominant mechanism that has been postulated is inhibition of Rho and its activation to Rho kinase. Type 2 diabetes is characterized by hyperglycemia, insulin resistance and insulin deficiency. The insulin resistance contributes to the abnormal lipid profile associated with type 2 diabetes. Dyslipidemia contributes to increased cardiovascular events in patients with type 2 diabetes. A linear relationship exists between cholesterol levels and cardiovascular diseases in diabetics even if we ignore the baseline LDL. By predominantly lowering LDL-Cholesterol and due to minor effects on other lipoproteins, statins appear to be beneficial. In Heart Protection Study which was done in diabetics, the decrease in cardiovascular events like first major coronary event, stroke were to the tune of 22% as compared to placebo. It was recommended by American Diabetes Association that statin therapy should be initiated in individuals with diabetes and other cardiovascular risk factors with target LDL cholesterol of 100 mg/dL. Investigators are also of the opinion that statin therapy should depend not on the LDL levels but the cardiovascular complications accompanying diabetes. Other studies wh Continue reading >>
Association Of Lipoproteins, Insulin Resistance, And Rosuvastatin With Incident Type 2 Diabetes Mellitus Secondary Analysis Of A Randomized Clinical Trial
Importance Statins decrease levels of low-density lipoprotein (LDL) and triglycerides as well as cardiovascular events but increase the risk for a diagnosis of type 2 diabetes mellitus (T2DM). The risk factors associated with incident T2DM are incompletely characterized. Objective To investigate the association of lipoprotein subclasses and size and a novel lipoprotein insulin resistance (LPIR) score (a composite of 6 lipoprotein measures) with incident T2DM among individuals randomized to a high-intensity statin or placebo. Design, Setting, and Participants This secondary analysis of the JUPITER trial (a placebo-controlled randomized clinical trial) was conducted at 1315 sites in 26 countries and enrolled 17 802 men 50 years or older and women 60 years or older with LDL cholesterol levels less than 130 mg/dL, high-sensitivity C-reactive protein levels of at least 2 mg/L, and triglyceride levels less than 500 mg/dL. Those with T2DM were excluded. A prespecified secondary aim was to assess the effect of rosuvastatin calcium on T2DM. Incident T2DM was monitored for a median of 2.0 years. Data were collected from February 4, 2003, to August 20, 2008, and analyzed (intention-to-treat) from December 1, 2013, to January 21, 2016. Interventions Rosuvastatin calcium, 20 mg/d, or placebo. Main Outcomes and Measures Size and concentration of lipids, apolipoproteins, and lipoproteins at baseline (11 918 patients with evaluable plasma samples) and 12 months after randomization (9180 patients). The LPIR score, a correlate of insulin resistance, was calculated as a weighted combination of size and concentrations of LDL, very low-density lipoprotein (VLDL), and high-density lipoprotein (HDL) particles. Results Among the 11 918 patients (4334 women [36.4%]; median [interquartile range] Continue reading >>
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The Effects Of Atorvastatin And Rosuvastatin On Oxidative Stress In Diabetic Patients - Sciencedirect
Volume 22, Issue 3 , June 2011, Pages 249-253 Diabetes is associated with abnormalities in lipid profile and increased oxidative stress. Statins are preferred agents in diabetic patients due to their antioxidant and LDL-C lowering effects. This study is designed to compare the effects of atorvastatin and rosuvastatin on low density lipoprotein cholesterol (LDL-C), lipid hydroperoxide (LOOH), total oxidant status (TOS) and total antioxidant capacity (TAC) in diabetic patients with hyperlipidemia. Sixty two patients who have type 2 diabetes mellitus with serum LDL levels more than 100mg/dL were randomly assigned to receive atorvastatin 20mg (n=31) or rosuvastatin 10mg (n=31). Blood tests were performed at the beginning of the study and after three months. There were no statistically significant differences in the pre- and after treatment levels of the LDL-C between groups. TAC values were increased in both groups and statistically significant in the former group (p=0.007). There was no diferrence between the change percentages ((after treatment TACpretreatment TAC)/pretreatment level) of TAC between two treatment groups. The effects of two drugs on the other oxidative parameters were not significantly different. Both atorvastatin and rosuvastatin may be helpful in reducing increased oxidative stress in diabetic patients with hyperlipidemia. Continue reading >>
Risk Of Diabetes With Statins
TORONTO, ON The debate about the potential risks of new-onset diabetes in statin-treated patients is addressed in two separate studies published by Canadian researchers looking at patients treated with the LDL-lowering drugs[ 1 , 2 ]. While one study is reassuring for older patients treated with statins, with researchers finding no evidence of an increased risk of diabetes in acute coronary syndrome (ACS) patients, the other suggests that the more potent statins, such as rosuvastatin (Crestor, AstraZeneca), atorvastatin, and simvastatin, do pose an increased risk compared with pravastatin. In a study published online May 14, 2013 in Circulation: Cardiovascular Quality and Outcomes, Dr Dennis Ko (Sunnybrook Health Sciences Center, Toronto, ON) and colleagues explain that while clinical-practice guidelines for ACS patients advocate for the use of intensive-dose statin therapy, the data suggesting an increased risk of diabetes with the drugs have raised some concerns. The group analyzed data of more than 17 000 patients 65 years of age and older hospitalized with MI in Ontario, Canada, between 2004 and 2010. Just over 52% of the ACS patients were treated with intensive statin therapy, defined as atorvastatin >40 mg, rosuvastatin >20, and simvastatin>60 mg. Atorvastatin <40 mg, rosuvastatin <20 mg, simvastatin <60 mg, and any dose of fluvastatin, lovastatin, and pravastatin, were considered moderate-dose statin therapy and prescribed to 48% of the treated patients. In total, 8540 matched pairs who had a similar likelihood of receiving intensive-dose or moderate-dose statin therapy were included in the analysis. Five years after hospitalization for ACS, 13.6% of patients who received intensive statin therapy had a new diagnosis of diabetes. Comparatively, 13.0% of patients Continue reading >>
Cholesterol-lowering Drugs May Be Linked To Diabetes
You may have concerns about taking a cholesterol-lowering statin drug, such as atorvastatin (Lipitor and generic), rosuvastatin (Crestor), and simvastatin (Zocor and generic), after a recent study linked those drugs to an increased risk of type 2 diabetes. But Consumer Reports Best Buy Drugs experts say the heart-protective benefit of statins usually outweighs the risk of diabetes, so don’t skip a statin if you need one to lower your cholesterol. Diabetes isn’t a new side effect of statins. The Food and Drug Administration added it to the label of all statins in 2012 based on a review of studies that found a slightly elevated risk. For example, one study that reviewed 13 randomized, controlled clinical trials of statins found that 4.9 percent of people who took one of the drugs for 4 years developed diabetes compared with 4.5 percent of those who didn’t take a statin. Lower Cholesterol vs. Higher Blood Glucose The new study, published in the Journal of General Internal Medicine, raises questions about whether the diabetes risk is higher than previously thought. Researchers looked at medical data of nearly 7,000 men and women with an average age of 53. About 31 percent of those who took a statin for an average of 5.5 years developed diabetes compared with 19 percent of those who didn’t. But since the study was not a randomized, controlled study—the gold standard for determining whether a drug causes a particular side effect—it’s not known for sure that the increase in diabetes was entirely due to statins. The study participants might have had other factors that contributed to the development of diabetes. "All we can say," says Ishak Mansi, M.D., an internist at the Veteran's Hospital in North Texas and co-author of the study, "[is] that in the healthy popul Continue reading >>
Comparison Of Rosuvastatin And Atorvastatin For Lipid Lowering In Patients With Type 2 Diabetes Mellitus: Results From The Uranus Study
Comparison of rosuvastatin and atorvastatin for lipid lowering in patients with type 2 diabetes mellitus: results from the URANUS study Berne et al; licensee BioMed Central Ltd.2005 The Use of Rosuvastatin versus Atorvastatin iN type 2 diabetes mellitUS (URANUS) study compared rosuvastatin with atorvastatin for the reduction of low-density lipoprotein cholesterol (LDL-C) in patients with type 2 diabetes. After a 6-week dietary run-in, patients aged 18 years with type 2 diabetes and LDL-C 3.3 mmol/L were randomised to double-blind treatment with rosuvastatin 10 mg (n = 232) or atorvastatin 10 mg (n = 233) for 4 weeks. Doses were then titrated up to a maximum of rosuvastatin 40 mg or atorvastatin 80 mg over 12 weeks to achieve the 1998 European LDL-C goal (<3.0 mmol/L). Rosuvastatin reduced LDL-C levels significantly more than atorvastatin during the fixed-dose and titration periods (p < 0.0001). Significantly more patients reached the 1998 LDL-C goal with rosuvastatin 10 mg compared with atorvastatin 10 mg at 4 weeks (81% vs 65%, p < 0.001). At 16 weeks, significantly more patients achieved their LDL-C goal with rosuvastatin compared with atorvastatin (94% vs 88%, p < 0.05) and more patients receiving rosuvastatin remained at their starting dose with reduced requirement for dose titration. At 4 weeks, 65% of rosuvastatin patients had reached their 2003 European LDL-C goal (< 2.5 mmol/L), compared with 33% of atorvastatin patients (p < 0.0001). Both treatments were similarly well tolerated with no unexpected safety concerns. At the start dose and following dose titration, rosuvastatin was significantly more effective than atorvastatin at reducing LDL-C and achieving European LDL-C goals in patients with type 2 diabetes. AtorvastatinRosuvastatinUrinary Albumin ExcretionCh Continue reading >>
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Rosuvastatin And Diabetes: When The Evidences Talk.
Abstract Diabetes increases the risk of cardiovascular disease; however, this risk is further increased as a result of other factors. This observation is particularly relevant with regard to lipid abnormalities. Although diabetic dyslipidemia is characterized by hypertriglyceridemia, low HDL-cholesterol, and small dense LDL particles, the main determinant of the role of dyslipidemia in the prognosis of diabetics is LDL cholesterol. In recent years, LDL cholesterol targets have become progressively lower, and most current recommendations establish an LDL cholesterol target of <70 mg/dL for diabetics. This target can only be achieved using potent statins at adequate doses. Although it has been suggested that statins may interfere with glycemic metabolism, the benefits of reducing LDL cholesterol by statins are much greater than this possible deleterious effect. Rosuvastatin is one of the most potent statins available. Several studies have shown that it effectively reduces LDL cholesterol to recommended targets in diabetics. Moreover, rosuvastatin modestly increases HDL cholesterol and decreases triglycerides. The risk of side effects is low, as is the risk of interactions with other drugs. In this manuscript, the efficacy and safety profile of rosuvastatin in diabetic population is reviewed. Continue reading >>
A Review Of The Efficacy Of Rosuvastatin In Patients With Type 2 Diabetes.
1. Int J Clin Pract Suppl. 2004 Oct;(143):30-40. A review of the efficacy of rosuvastatin in patients with type 2 diabetes. (1)National Public Health Institute, Helsinki, Finland. [email protected] It has been estimated that 92% of individuals with type 2 diabetes, withoutcardiovascular disease (CVD), have a dyslipidaemic profile. Several guidelines oncardiovascular risk now recommend that patients with diabetes should beconsidered at high risk of CVD and should thus receive lipid-lowering therapy to reduce low-density lipoprotein cholesterol (LDL-C) to below 2.5 mmol/L. Sincetheir introduction in 1987, statins have revolutionized the management of CVD.The most recent statin to be introduced, rosuvastatin, has been shown to be themost effective at lowering LDL-C, as well as consistently raising HDL-C acrossthe 10-40 mg dose range. This has been confirmed by many studies, including theMeasuring Effective Reductions in Cholesterol Using Rosuvastatin Therapy (MERCURYI) study in which rosuvastatin 10 mg was shown to be more effective than commonlyused doses of other statins, both for LDL-C reduction and achieving treatmenttarget goals. The effectiveness of rosuvastatin has also been studied in type 2diabetes patients in three studies: the URANUS (Use of Rosuvastatin vs.Atorvastatin iN type 2 diabetes mellitUS), ANDROMEDA (A raNdomized, Double-blind study to compare Rosuvastatin [10 & 20 mg] and atOrvastatin [10 & 20 Mg] inpatiEnts with type II DiAbetes) and CORALL (COmpare Rosuvastatin [10-40 mg] with Atorvastatin [20-80 mg] on apo B/apo A-1 ratio in patients with type 2 diabetesmeLLitus and dyslipidaemia) studies. URANUS and ANDROMEDA showed rosuvastatin to be more effective than atorvastatin at reducing LDL-C and achieving treatmenttarget goals. CORALL demonstrate Continue reading >>
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Listen - Statin Standoff: Does Rosuvastatin Tip The Balance In Diabetic Patients?
BARCELONA, Spain Sunday 31 August: When it comes to cholesterol-lowering statin medications for patients with type 2 diabetes, rosuvastatin may be a better choice than atorvastatin, according to the findings of a new study presented today at ESC Congress 2014. Statins have been shown to slightly increase the risk of new-onset diabetes but few studies have been done to investigate their impact on existing diabetes. Such data would greatly contribute to decision-making when these patients are treated in routine clinical settings, said Hisao Ogawa, MD, PhD, investigator of the LISTEN (LIpid lowering with highly potent Statins in hyperlipidemia with Type 2 diabetes patiENts) trial. Results of the trial, presented as an ESC Hot Line, suggest rosuvastatin may have an initially more favourable effect on glucose levels compared to atorvastatin, making it a wiser choice especially in diabetes patients who struggle to keep glucose levels down, said Professor Ogawa, from the Graduate School of Medical Sciences at Kumamoto University in Kumamoto, and Deputy Director General of the Hospital, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan. The study randomised patients with type 2 diabetes and high cholesterol to either 5mg of rosuvastatin daily (n=514) or 10mg of atorvastatin daily (n=504) for a year. An increase in statin dose was allowed only if a patients cholesterol levels were not controlled adequately according to Japanese guidelines, but decisions about adjusting diabetes medication were left to the treating physicians discretion. The primary endpoint of the trial was the change from baseline in non-HDL cholesterol (total cholesterol minus HDL or good cholesterol) and glycated hemoglobin (HbA1c), an indication of blood glucose. At the end of the study both Continue reading >>
The Role Of Statins In Diabetes Treatment
In Brief Diabetes is considered a risk equivalent for coronary heart disease (CHD). The use of statins for primary and secondary prevention in patients with diabetes is well established and supported by robust data from randomized, controlled trials and national guidelines. The American Diabetes Association recommends that individuals with diabetes and a history of cardiovascular disease (CVD), as well as those > 40 years of age without CVD but with CVD risk factors, should be treated with a statin regardless of their baseline LDL cholesterol concentration. This review explains the rationale behind considering diabetes a CHD risk equivalent and summarizes the data for statin use in adults with diabetes without (primary prevention) and with (secondary prevention) established CVD. Although individuals with diabetes are at an increased risk for CVD and benefit from statin therapy, the risk of CVD in people with diabetes is heterogeneous. It therefore may be reasonable to match the intensity of statin therapy with patients' baseline CVD risk. Diabetes is a leading public health concern. More than 8% of the U.S. population has diabetes, with the incidence and prevalence expected to increase during the next several years.1,2 Of particular concern is the increased risk of developing incident coronary heart disease (CHD) and the increased risk of cardiac death.3 In fact, two out of three adults with diabetes who are > 65 years of age die as a result of CHD, and this risk increases steeply with the addition of other risk factors.4,5 Based on observations that patients with type 2 diabetes and no history of myocardial infarction (MI) have the same risk of MI and CHD mortality as patients without diabetes with a prior MI,6 current guidelines consider diabetes a CHD risk equivalent Continue reading >>
Rosuvastatin Increases Diabetes Risk, Health Expert Warns
Home Prediabetes Type 1 Type 2 Food + Recipes Living With Diabetes Treatment Complications Insurance Shop Explore Tweet Type 2 diabetes mellitus is a metabolic disorder that results in hyperglycemia (high blood glucose levels) due to the body: Being ineffective at using the insulin it has produced; also known as insulin resistance and/or Being unable to produce enough insulin Type 2 diabetes is characterised by the body being unable to metabolise glucose (a simple sugar). This leads to high levels of blood glucose which over time may damage the organs of the body. From this, it can be understood that for someone with diabetes something that is food for ordinary people can become a sort of metabolic poison. This is why people with diabetes are advised to avoid sources of dietary sugar. The good news is for very many people with type 2 diabetes this is all they have to do to stay well. If you can keep your blood sugar lower by avoiding dietary sugar, likely you will never need long-term medication. Type 2 diabetes was formerly known as non-insulin-dependent or adult-onset diabetes due to its occurrence mainly in people over 40. However, type 2 diabetes is now becoming more common in young adults, teens and children and accounts for roughly 90% of all diabetes cases worldwide. How serious is type 2 diabetes? Type 2 diabetes is a serious medical condition that often requires the use of anti-diabetic medication, or insulin to keep blood sugar levels under control. However, the development of type 2 diabetes and its side effects (complications) can be prevented if detected and treated at an early stage. In recent years, it has become apparent that many people with type 2 diabetes are able to reverse diabetes through methods including low-carb diets, very-low-calorie diets and Continue reading >>