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Statin Induced Diabetes Reversible

Risk Of Diabetes, Cognitive Problems With Statins Sparks Debate About Overuse

Risk Of Diabetes, Cognitive Problems With Statins Sparks Debate About Overuse

Updated US Food and Drug Administration (FDA) warnings that use of cholesterol-lowering statins can increase the risk of developing diabetes, liver injury, cognitive problems, and muscle injury for some patients have renewed criticism about overuse of this class of medications. Last week, the FDA announced changes to the labels of statin medications, which include atorvastatin, fluvastatin, lovastatin, pitavastatin, pravastatin, rosuvastatin, simvastatin, and combination products containing these drugs. The label changes indicate that these products may be associated with memory loss or confusion, an increased risk of developing type 2 diabetes, and increased risk of muscle injury when used in combination with drugs for the treatment of HIV or hepatitis C virus infection. The agency noted that it found evidence of mild and reversible memory loss and confusion from reports in its Adverse Events Reporting System and in the medical literature. Additionally, the agency noted that a large clinical trial and a meta-analysis reported an increased risk of diabetes among statin users. “FDA continues to believe that the cardiovascular benefits of statins outweigh these small increased risks,” the agency stated. However, in an editorial in the New York Times on Sunday, prominent cardiologist Eric J. Topol, MD, professor of genomics at the Scripps Research Institute in La Jolla, California., argued that the magnitude of the risk of diabetes is large enough to be a concern, particularly for individuals taking statins to prevent a first heart attack or other cardiovascular problem. Topol said the data suggest that 1 in 200 patients taking one of the most potent statins—simvastatin, atorvastatin, and rosuvastatin—will develop diabetes. For a patient with heart disease or a pre Continue reading >>

Fda Warns On Statin Drugs

Fda Warns On Statin Drugs

The Food and Drug Administration warned that patients taking cholesterol-fighting statins face a small increase in the risk of higher blood-sugar levels and of being diagnosed with diabetes, raising concerns about one of the country's most widely prescribed groups of drugs. The federal safety agency said Tuesday it plans to require drug makers to add the diabetes-risk language to the "warnings and precautions" section of the labels on statin drugs. Statins include top-selling brand names such as Lipitor, Crestor, Zocor and a dozen or so other branded and generic versions under various names. The drugs are prescribed to more than 20 million Americans a year, at a cost of more than $14 billion in 2011, according to the research firm IMS Health. The warning isn't expected to prompt doctors to stop prescribing statins for patients with multiple risk factors for heart attack. Cardiologists said for many patients, the benefits of statins still outweigh these risks. The diabetes issue is "real" but "not a huge effect," said Robert Califf, vice chancellor for clinical research and a cardiologist at Duke University Medical Center. "Informing people is a good thing, but for the vast majority of people who really need to be on a statin, this shouldn't change what they do." But some physicians cautioned that the risk wasn't insignificant and that patients at lower risk for heart problems might want to reassess whether they should remain on statins. "The diabetes issue is a really big deal. We're overcooking the statin use," said Eric J. Topol, a prominent cardiologist and chief academic officer of Scripps Health in LaJolla, Calif. In addition, the FDA said labels for statin drugs now will contain information about patients experiencing memory loss and confusion, though this side ef Continue reading >>

Statins And Diabetes

Statins And Diabetes

Statins, the group of cholesterol-lowering drugs that includes atorvastatin (brand name Lipitor), simvastatin (Zocor), and rosuvastatin (Crestor), have been under increased scrutiny during the last couple of years as studies have linked them to an elevated risk of Type 2 diabetes. Most recently, as David Spero noted in a January blog post here at DiabetesSelfManagement.com, a study of statins in postmenopausal women found a 48% higher risk of diabetes among women who took one of these drugs compared with those who did not. Since this was not a randomized clinical trial, its results are not conclusive. But enough studies have raised concerns that last week, as a New York Times opinion piece notes, the US Food and Drug Administration (FDA) added a warning on diabetes risk to the label of all statins. As the Times piece explains, statins are the most widely prescribed drugs in the world, and they have been in use since the 1980’s. But more powerful statins have achieved widespread use only in the last decade or so, and it appears that these drugs are associated with the greatest diabetes risk. With 20 million Americans taking statins and an estimated risk of developing diabetes from the drugs of 1 in 200, 100,000 people could have diabetes as a result of these drugs. Furthermore, the piece notes, among people without existing heart disease who take statins, the drugs prevent only one heart attack or stroke for every 50 people taking them. Although it is clear from those numbers that statins provide no overwhelming heart-risk reduction or diabetes-risk increase to most people who take them, it is also clear that the heart-related benefit from these drugs is statistically greater than their diabetes-related risk. One particular study, published last year in the Journal of Continue reading >>

Effect Of Vitamin D On Atorvastatin Induced Blood Sugar Changes In Wistar Albino Rats

Effect Of Vitamin D On Atorvastatin Induced Blood Sugar Changes In Wistar Albino Rats

Abstract Background: Statins are hypocholestrolemic agents used in atherosclerotic vascular disorders. They act by inhibiting hepatic hypoxanthine methyl glutaryl CoA reductase enzyme. They are reported to cause hyperglycemia as an important adverse event. This study was conducted to investigate atorvastatin induced blood sugar changes in Wistar, albino, male rats and the influence of vitamin D on the blood sugar changes. Methods: Forty, 12 weeks old male, Wistar albino rats, were selected and randomly allocated to 5 groups of 8 animals, each. Animals in Group 1 were administered normal saline orally and served as controls. Group 2 and 3 received atorvastatin 2 mg and 4 mg, respectively, orally. Group 4 and 5 received 200 IU of vitamin D along with 2 mg and 4 mg of atorvastatin respectively, orally. The drugs were administered once, every day for 3 months. Body weight and fasting blood sugar were estimated at baseline and at the end of every month for 3 months. Results: In control animals (Group 1) and animals treated with atorvastatin along with vitamin D (Group 4 and 5), fasting blood sugar levels did not change significantly and the body weight increased. In animals treated with only atorvastatin (Group 2 and 3), fasting blood sugar was significantly increased and body weight did not change. Conclusions: This study has demonstrated that chronic use of atorvastatin 2 and 4 mg may lead to fasting hyperglycemia and it could be prevented by co-administration of 200 IU of vitamin D, in male Wistar albino rats. Randomized control studies in humans are further required to recommend routine use of vitamin D in patients receiving atorvastatin. References Pella D, Rybar R, Mechirova V. Pleiotropic effects of statins. Acta Cardiol Sin. 2005;21:190-8. Lipitor® Prescribing Inf Continue reading >>

Statin

Statin

This article is about the group of cholesterol-lowering drugs. For the amino acid, see Statine. For inhibiting hormones, see Releasing and inhibiting hormones. Statins, also known as HMG-CoA reductase inhibitors, are a class of lipid-lowering medications. Statins have been found to reduce cardiovascular disease (CVD) and mortality in those who are at high risk. The evidence is strong that statins are effective for treating CVD in the early stages of the disease (secondary prevention) and in those at elevated risk but without CVD (primary prevention).[1][2] Side effects of statins include muscle pain, increased risk of diabetes mellitus, and abnormalities in liver enzyme tests.[3] Additionally, they have rare but severe adverse effects, particularly muscle damage.[4] They inhibit the enzyme HMG-CoA reductase which plays a central role in the production of cholesterol. High cholesterol levels have been associated with cardiovascular disease (CVD).[5] As of 2010, a number of statins are on the market: atorvastatin, fluvastatin, lovastatin, pitavastatin, pravastatin, rosuvastatin, and simvastatin.[6] Several combination preparations of a statin and another agent, such as ezetimibe/simvastatin, are also available. In 2005, sales were estimated at US$18.7 billion in the United States.[7] The best-selling statin is atorvastatin also known as Lipitor, which in 2003 became the best-selling pharmaceutical in history.[8] The manufacturer Pfizer reported sales of US$12.4 billion in 2008.[9] Due to patent expirations, several statins became available in 2016 as less expensive generics.[10] Medical uses[edit] Clinical practice guidelines generally recommend people try "lifestyle modification", including a cholesterol-lowering diet and physical exercise, before statin use. Statins or Continue reading >>

Statin-induced Diabetes: Incidence, Mechanisms, And Implications

Statin-induced Diabetes: Incidence, Mechanisms, And Implications

Go to: Emergence of new diabetes in RCTs A clinically relevant concern with statin therapy is a significantly increased risk of new-onset diabetes in patients on statin therapy. The JUPITER trial reported a 25% increase with rosuvastatin 20 mg, over a median follow-up of 1.9 years, compared to those on placebo 9. Since then, several meta-analyses have confirmed a smaller but significant increase with various statins ( Table 1). The analysis by Sattar et al. in 91,140 subjects showed a 9% overall risk in 13 RCTs over a mean period of 4.0 years (odds ratio [OR] 1.09; 95% CI 1.02–1.17) 10. In a subsequent meta-analysis of five intensive-dose statin trials, Preiss et al. reported a significant increase in diabetes incidence with more intensive- vs. moderate-dose statin (OR 1.12; 95% CI 1.04–1.22) in 32,752 subjects over a mean follow-up of 4.9 years 11. In general, there was no relationship between % LDL-C reduction and incident diabetes. Further analysis of baseline characteristics of the various trials reported a strong relationship between features of metabolic syndrome or pre-diabetes (age, body mass index [BMI], hypertension, fasting glucose, and triglycerides) at baseline and subsequent development of diabetes 12– 14. Of note, the risk–benefit ratio for CVD still clearly favored statin therapy in various studies, including JUPITER, in primary prevention 13, several secondary prevention studies 12, 14, and a meta-analysis of secondary prevention studies by Preiss et al. 11. Thus, regardless of whether or not diabetes was diagnosed during statin therapy, the CVD outcomes were reduced on statin therapy compared to those observed with placebo. Authors n Age (years) Duration of follow-up (years) Adjusted odds ratio (95% confidence interval) Comments Sattar et al. 1 Continue reading >>

New Statin Study Confirms Scary Link To Diabetes

New Statin Study Confirms Scary Link To Diabetes

Statin-type cholesterol-lowering drugs like atorvastatin, lovastatin and simvastatin are supposed to prevent heart attacks and strokes. New research from Finland suggests that such drugs may increase the risk of developing type 2 diabetes by 46 percent, a condition that is strongly linked to heart attacks and strokes. What gives? In 2003 People’s Pharmacy Readers Were Alerted We received a signal from readers more than a decade ago that statins could Trigger diabetes in people with normal blood sugar and Make control of diabetes more challenging in people who already had the disease. As long ago as 2003 we began getting messages like this one: “Since we started on Lipitor, our blood sugar has been rising rapidly. My husband asked the doctor about changing to Tricor, but he was told it would not help him much and he should stay with Lipitor. It seems that Lipitor is affecting our blood sugar. Is this possible?” At that time most physicians did not believe statins could affect blood sugar. We scoured the official prescribing information for atorvastatin (Lipitor) and found hidden away in a long list of other possible adverse reactions the word “hyperglycemia.” In other words, elevated blood sugar. But this side effect was buried along with lots of other seemingly rare complications. Most patients were never warned that there was a connection between Lipitor and blood sugar elevations. JUPITER and Diabetes: Dodging and Weaving In 2008 a study called JUPITER (New England Journal of Medicine, Nov. 8, 2008) revealed a link between rosuvastatin (Crestor) and type 2 diabetes. Nowhere in the abstract or the conclusions was there mention of this connection. That is what busy doctors often look at rather than read the entire article. If, however, you took the time to act Continue reading >>

Crestor Side Effects

Crestor Side Effects

Even as the U.S. Food and Drug Administration (FDA) approved Crestor to treat cholesterol in 2003, some regulators within the agency still voiced reservations about the drug’s safety. Crestor is part of a class of cholesterol drugs called statins, and while statins have been around since the 1980s, Crestor was a powerful new version. Though the FDA knew about cases of a rare form of muscle damage during the drug’s premarketing trials, the agency believed at the time the rate was similar to other statins already on the market. But in the first year after Crestor was approved, an analysis of adverse event reports to the FDA indicated the number of rhabdomyolysis cases among Crestor users was higher than for users of other statins. Rhabdomyolysis can lead to severe kidney injury or failure. In 2005, just over a year after approving Crestor, the FDA required its manufacturer, AstraZeneca, to add a warning to the drug’s label about the risk of rhabdomyolysis and other muscle injuries. Further postmarket studies in the years after Crestor’s initial approval would highlight or examine previously unknown or underestimated risks of serious side effects. Possible Serious Side Effects of Crestor: Rhabdomyolysis (a form of serious muscle damage that can cause kidney problems) Kidney failure Hemorrhagic stroke Tendon rupture Decreased cognition, such as memory loss & amnesia Kidney damage Type 2 diabetes Muscle-related symptoms Despite reports of sometimes serious side effects, Crestor became one of the most popular brand-name drugs in the U.S. Its success is due in part to its effectiveness in addressing cardiovascular disease (CVD). In 2010, the FDA approved Crestor to prevent heart attacks, strokes and other cardiovascular disease — the leading cause of death in the U.S Continue reading >>

Controlling Cholesterol With Statins

Controlling Cholesterol With Statins

Whether you’re taking a statin or not, the following tips can help keep your cholesterol in check: Talk with your healthcare provider about how often you should have your cholesterol checked. Maintain a healthy weight. Exercise regularly. When buying groceries, use the Nutrition Facts Label to choose foods lower in saturated fat, trans fats, and calories. Eat more fruits and vegetables. And remember, you should not stop taking any cholesterol-lowering medication you may be on without first talking to your healthcare provider. Subscribe: FDA Consumer Health Information You go to the gym faithfully, and try to watch your diet. But after your annual physical, you find out that your blood cholesterol is surprisingly high. Your doctor calls you back to discuss taking a medication known as a statin. Here are some commonly asked questions about cholesterol and statins. 1. What are statins? How do they work? Statins are a class of medicines used to lower cholesterol in the blood. Most of the cholesterol in your blood is made by the liver. Statins work by reducing the amount of cholesterol made by the liver and by helping the liver remove cholesterol that is already in the blood. According to James P. Smith, M.D., M.S., deputy director of the Division of Metabolism and Endocrinology at the U.S. Food and Drug Administration (FDA), “An important first step is to have a discussion with your healthcare provider about your risk of having heart disease or a stroke, how a statin would reduce that risk, and any side effects that you should consider.” 2. Why is it important to keep cholesterol levels in the blood low? Your body needs cholesterol, but too much of it in your blood can lead to buildup on the walls of your arteries (this buildup is called “plaque”), putting you at Continue reading >>

Ask The Pharmacist: The Diabetes Statin Connection

Ask The Pharmacist: The Diabetes Statin Connection

Did you get diabetes after starting a statin drug? This is very common, statin users often find better cholesterol ratios over time, but higher blood glucose. Sit down for my next comment: It’s entirely possible that you’ve been diagnosed with Type 2 diabetes when in fact you just have hyperglycemia (high blood sugar) and it’s just a side effect, and the result of your statin. The good news is your “diabetes” may even be reversible when your statin treatment is over. I’ve counted 84 people who got off their statin and reversed their “diabetes.” It may be news to you, but many studies and reports have shown that statins can cause raise blood sugar, which is sadly and disgracefully mistaken for “diabetes.” Now you’re on the expensive medication merry-go-round. Another bombshell coming: People with high cholesterol have a lower risk of getting diabetes, which is in keeping with what I just told you about statins triggering the condition. I’ve got the most current information now. Researchers looked at the rates of diabetes among 63,385 Dutch residents in the Netherlands between 1994 and 2014. Of these participants, 25,137 had inherited “Familial Hypercholesterolemia” which is a condition that means high cholesterol from their inherited genes. These people with the genetic snp (pronounced snip) coding for high cholesterol displayed significantly lower rates of Type 2 diabetes. The details were reported in the March 2015 edition of JAMA if you want to look it up. The prevalence of Type 2 diabetes was actually 38 percent lower, which suggests high cholesterol protects against diabetes. Keep in the back of your mind how people taking statin drugs face an increased risk of developing diabetes, anywhere from nine to 46 percent depending on what study Continue reading >>

New Fda Warnings On Statins' Side Effects - Diabetes & Cognitive Dysfunction - The Studies Behind The Warnings & What The Experts Have To Say About It? Dr. Eric Topol, Dr. Beatrice Golomb, Dr. Joann Manson For Starters.

New Fda Warnings On Statins' Side Effects - Diabetes & Cognitive Dysfunction - The Studies Behind The Warnings & What The Experts Have To Say About It? Dr. Eric Topol, Dr. Beatrice Golomb, Dr. Joann Manson For Starters.

NYT-Stuart Bradford Note: This is a very long post that includes the latest FDA statin warnings, as well as posts I have previously written that explain in more detail the side effects of statins--what they are, why they occur, and what increases your chances of experiencing them. Last Week's Breaking News: FDA adds warnings to statin labels While Drs. Steven Nissen & Marc Gillinov new book, "Heart 411: the ONLY Guide to Heart Health You'll Ever Need", minimizes the adverse effects of statins, the FDA has finally decided to publicly alert us to two of statin's more alarming side effects. All statins will now have label warnings to the effect that high-dose statins significantly increase the risk of diabetes, and statins can have cognitive side effects, albeit reversible. Steven E. Nissen, chairman of cardiovascular medicine at the Cleveland Clinic, said, "There is no question that statins slightly increase the risk of a diabetes diagnosis and of slightly higher blood sugar, but I think this has no impact on the risk-benefit assessment. I know I can lower the [relative] risk of death, stroke and heart attack by about 30%" in patients at high risk of such cardiovascular events. (WSJ 2/29/12) Read the WSJ article here. Dr. Eric Topol, one of the country's top cardiologist, and the former chairman of cardiology at the Cleveland Clinic (now at the Scripps Research Instiute) wrote a "must read" Op/Ed piece in the New York Times on March 4, 2012, The Diabetes Dilemma for Statin Users, with a decidedly different view of diabetes risk associated with statins. Topol's Op/Ed was followed yesterday by NYT's health columnist, Tara Parker Pope's "A Heart Helper May Come at a Cost for the Brain"--highlighting the cognitive side effects of statins. Joe & Terry Graedon of The People's P Continue reading >>

Side Effects Prompt Patients To Stop Cholesterol Drugs

Side Effects Prompt Patients To Stop Cholesterol Drugs

With one-quarter of adults over age 45 taking cholesterol-lowering statin drugs, it figures that more than a few people would have trouble sticking with the program. More than a few, actually. A big new study of statin use in the real world found that 17 percent of patients taking the pills reported side effects, including muscle pain, nausea, and problems with their liver or nervous system. That's a lot higher than the 5 to 10 percent reported in the randomized controlled trials that provided evidence for regulatory approval of the medicines. This study, which was published in Annals of Internal Medicine, looked at more than 100,000 people who'd been prescribed statins from 2000 through 2008 at two academic medical centers. About two-thirds of people with side effects quit taking statins. All in all, half of all the people who been prescribed the drugs quit them at last temporarily. Twenty percent quit for more than a year. It's tough to get people to take medicine to reduce the odds of disease years from now, notes Dr. Scott Grundy, a cholesterol researcher at UT Southwestern Medical Center in Dallas. "The vast majority of people don't have side effects," he wrote in an editorial accompanying the study. "Not continuing the drug has a lot more to do with people just not wanting to take drugs for a lifetime." People have decidedly mixed feelings about the side effects associated with statins, according to a 2012 NPR-Truven Health Analytics poll. The worry, of course, is that the ranks of statin quitters include people at high risk of heart disease, for whom the daily dose of cholesterol-lowering drug can reduce the risk of deadly heart attacks. "Statins are important drugs, especially for patients with known heart disease," says Dr. Alexander Turchin, an assistant profe Continue reading >>

Type 2 Diabetes Can Be Reversed In Just Four Months, Trial Shows

Type 2 Diabetes Can Be Reversed In Just Four Months, Trial Shows

Type 2 diabetes can be reversed in just four months by cutting calories, exercising and keeping glucose under control, a trial has shown. Although the condition is considered to be chronic, requiring a lifetime of medication, Canadian researchers proved it was possible to restore insulin production for 40 per cent of patients. The treatment plan involved creating a personalised exercise regime for each trial participant and reducing their calories by between 500 and 750 a day. The participants also met regularly with a nurse and dietician to track progress and continued to take medication and insulin to manage their blood sugar levels. After just four months, 40 per cent of patients were able to stop taking their medication because their bodies had begun to produce adequate amounts of insulin again. The researchers at McMaster University in Ontario, Canada, said the programme worked because it gave the insulin-producing pancreas ‘a rest.’ "The research might shift the paradigm of treating diabetes from simply controlling glucose to an approach where we induce remission and then monitor patients for any signs of relapse," said the study's first author, Dr Natalia McInnes, of McMaster. "The idea of reversing the disease is very appealing to individuals with diabetes. It motivates them to make significant lifestyle changes. “This likely gives the pancreas a rest and decreases fat stores in the body, which in turn improves insulin production and effectiveness." About | Diabetes The number of people in the UK with type 2 diabetes has trebled over the last two decades, rising from 700,000 in the 1990s to 2.8 million today, according to new figures from Cardiff University. The condition costs the NHS around £14 billion a year, but if the intervention worked at the same Continue reading >>

Summarizing The Current State And Evidence On Efficacy And Safety Of Statin Therapy

Summarizing The Current State And Evidence On Efficacy And Safety Of Statin Therapy

Adverse media coverage of "statin intolerance" has profound public health implications. Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of death in the United States and world-wide, based on data from the US Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO).1,2 More than 15.5 million Americans have coronary artery disease and every 42 seconds an American will have a myocardial infarction. One-third of those experiencing a coronary event die as a result.3 Statin therapy reduces major adverse cardiovascular events in patients with or at risk for ASCVD and the most recent guidelines from the American College of Cardiology and the American Heart Association (ACC/AHA) recommend moderate to high intensity statin administration in such patients.4 Statins have rare serious side effects, such as rhabdomyolysis and hepatotoxicity, and have been associated with increased incidence of diabetes and hemorrhagic stroke. Patients increasingly report symptomatic side effects, such as muscle or joint pain and weakness, preventing them from continuing statin therapy, a condition referred as "statin intolerance."5 Evidence on statin intolerance is derived principally from observational studies and reports to regulatory authorities of adverse events that have been attributed to a statin, and not from randomized clinical trials. However, the concept that statin intolerance is a common problem and might outweigh statin-associated benefits has been introduced in the medical literature and emphasized by the public media.6-8 This has profound public health implications with studies in the United Kingdom, Denmark, and Australia linking adverse media coverage with significantly increased reluctance among physicians to discuss and prescribe Continue reading >>

Susan Blum, Md: Actualizing “food As Medicine” In Real-world Practice

Susan Blum, Md: Actualizing “food As Medicine” In Real-world Practice

Food is medicine: It’s easy to say. To make it work in a modern medical practice is not quite so simple. "Dr. Susan Blum is a leader in applying the principles of functional medicine to the care of people with autoimmune diseases. The Blum Center for Health, her thriving clinic in Rye Brook, NY, is a prime example of a new practice model that supports a truly holistic approach. In this video, from the Heal Thy Practice 2014 conference, Dr. Blum gives an inside "nuts & bolts" look at her practice and shares key lessons she learned along the way. [ ...Read More ] Continue reading >>

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