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Statins And Diabetes

Statins Raise Diabetes Risk: Experts Sound New Alarm Over Cholesterol Pill

Statins Raise Diabetes Risk: Experts Sound New Alarm Over Cholesterol Pill

Those on high doses of the cholesterol-busting pills are more prone to suffer dangerous spikes in blood sugar levels. Scientists say an unwanted by-product of the drug is a link to the chronic condition. Studies show those prescribed statins are less likely to develop heart disease but the downside is it appears to make them more vulnerable to Type 2 diabetes. Researchers found over-75s are a third more likely to be struck down if they are taking statins. But the risk increased to 50 per cent for those on higher doses of the tablets. Dr Mark Jones, who led the research, said: “We found almost 50 per cent of women in their late-70s and 80s in the study took statins and five per cent were diagnosed with new onset diabetes. What is most concerning was we found a ‘dose effect’ where the risk of diabetes increased as the dosage of statins increased. “Over the 10 years of the study most of the women progressed to higher doses of statins. GPs and their elderly female patients should be aware of the risks.” The study will reignite debate over the safety of a drug taken by millions of Britons each day. A large-scale British review last year showed statins were the safest and most effective way of preventing heart attack and stroke but they still remain highly controversial. Professor Alan Sinclair, director of the Foundation for Diabetes Research in Older People, said: “Statin use and increased diabetes risk is not new and clinicians must continue to minimise risk due to the adverse effects of these drugs by careful prescribing but at the same time recognise clear cardiovascular benefits from their use. We found almost 50 per cent of women in their late-70s and 80s in the study took statins “In older people, who are already at increased diabetes risk from other cau Continue reading >>

Statins Significantly Increase Diabetes Risk In Older Women

Statins Significantly Increase Diabetes Risk In Older Women

Statins Significantly Increase Diabetes Risk in Older Women Brisbane, AustraliaThe risks of developing diabetes with statin use might be so great for older women that prescribers should consider discontinuing the cholesterol-lowering drugs. Thats according to a new Australian study that found women aged >75 had a significantly increased risk for diabetes, 33%, if they took statins. The University of Queenslandled research study pointed out that the risk increased to more than 50% in women taking higher doses of the drugs. We found that almost 50% of women in their late seventies and eighties in the study took statins, and 5% were diagnosed with new-onset diabetes, explained Mark Jones, PhD. Statins are highly prescribed in this age group but there are very few clinical trials looking at their effects on older women. He added, The vast majority of research is on 40- to 70-year-old men. To determine the risks, the study team performed an analysis of a population-based longitudinal cohort study with data linkage to the Australian national death index, and to national databases of nonhospital episodes of medical care and prescription medications dispensed between July 1, 2002, and August 31, 2013. Participants were 8,372 Australian women born between 1921 and 1926, who were alive on January 1, 2003, and did not have a diabetes diagnosis. The report notes that, during 10 years of follow up, 49% of the cohort had filled a prescription for statins and 5% had initiated treatment for new-onset diabetes. Statin exposure was found to be associated with a higher risk of treatment for new-onset diabetes (hazard ratio 1.33), which equates to a number needed to harm (NNH) of 131 for 5 years of exposure to statins. Risk increased with increasing dose of statin from the hazard ratio of Continue reading >>

Statins Linked To Increased Risk Of Type 2 Diabetes

Statins Linked To Increased Risk Of Type 2 Diabetes

Statins linked to increased risk of Type 2 diabetes Studies have shown a modest increase in diabetes risk among patients takingstatinsCredit:Press Association Lowering the "bad" form of cholesterol with statin drugs could increase diabetes risk, a study suggests. Scientists found that people with naturally lower levels of low-density lipoprotein (LDL) cholesterol were less likely to develop heart disease but slightly more vulnerable to Type 2 diabetes. Reducing LDL levels by takingstatinsmay have the same effect, they believe. Lead researcher Dr Michael Holmes, from Oxford University, said: "What we've shown in this study is that the role played by blood lipid levels in disease is a complex one. "While the effect of taking LDL cholesterol-lowering drugs such asstatinsmay slightly increase a person's risk of developing diabetes this effect is greatly outweighed by their benefits in the form of preventing people from suffering from a life-altering heart attack or stroke." The team analysed large data sets of information about genetic make-up to tease apart the possible effects on heart disease and diabetes risk of LDL and so-called "good" cholesterol, high-density lipoprotein (HDL), which is said to be protective. They also looked at the influence of triglyceride blood fats which are associated with heart disease. Cases of heart disease were more likely to occur among people with genetic mutations that increased their levels of LDL or triglycerides, the research showed. But genetic variants that raised either LDL or HDL cholesterol levels, and possibly triglyceride levels, slightly reduced the chances of developing Type 2 diabetes. Continue reading >>

Statin Use Linked To Increased Risk Of Type 2 Diabetes

Statin Use Linked To Increased Risk Of Type 2 Diabetes

Statin use is linked to an increased risk of type 2 diabetes among high-risk individuals, a new study reports. Statins are cholesterol-lowering drugs prescribed to reduce cardiovascular risks, but a variety of studies have shown the drugs have an association with type 2 diabetes development. These new findings were from a long-term US study of 3,234 patients at high risk of type 2 diabetes, all of whom had elevated BMIs and blood sugar levels. Participants took part in the US Diabetes Prevention Program Outcomes Study (DPPOS) and were randomised to receive different interventions to prevent type 2 diabetes. These included an intensive lifestyle programme, metformin treatment or a placebo drug. They were then followed for an average of 10 years. Fewer than four per cent of participants took statins at the study's start, but this figure increased to around a third of participants after 10 years. Moreover, statin use was associated with heightened type 2 diabetes risk irrespective of which treatment group a patient belonged to. Overall, statin use was associated with a 36 per cent increased risk of type 2 diabetes development compared to those who did not take the drugs. No link was observed between statin potency in diabetes risk, nor in regard to LDL cholesterol. While this was an observational study and no causal link between statin use and diabetes risk can be made, the researchers point to evidence suggesting that statins can impair insulin production. This, they believe, could help explain the diabetes risk. They added, however, that the potential increased risk of diabetes should always be weighed carefully against any benefits of statins, which include reduced risk of a heart attack and stroke in certain groups of people. The findings appear online in the online jo Continue reading >>

Statins Increase Diabetes Risk By Up To 50% In Older Women

Statins Increase Diabetes Risk By Up To 50% In Older Women

Statins Increase Diabetes Risk by up to 50% in Older Women Statin therapy increases the risk of new-onset diabetes in elderly women by 33%, and the higher the dose, the greater the risk, a new analysis of the observational Australian Longitudinal Study on Women's Health shows. "Clearly, statins have beneficial effects, including a reduction in the risk of cardiovascular events; however, the dose-response effect we observed suggests that it may be wise to avoid using higher doses of statins in older women," lead author Mark Jones, MD, senior lecturer, school of public health, the University of Queensland, Brisbane, Queensland, told Medscape Medical News in an email. "GPs and their elderly female patients should be aware of the risks," Dr Jones added in a University of Queensland statement, noting that those elderly women taking statins "should be carefully and regularly monitored for increased blood glucose to ensure early detection and management of diabetes." And, he and his colleagues suggest, it may be the case that statins could be stopped altogether in some elderly women. Women Take Statins on Average, for 6.5 Years The new analysis included 8372 Australian women aged between 76 and 82 years at baseline who were followed for 10 years; it is published in the March issue of Drugs and Aging. Dr Jones and colleagues note that the majority of participants in statin trials have been males and that females, especially elderly ones, have been underrepresented. "Our group has expertise and experience in women's health, including being involved with the Australian Longitudinal Study on Women's Health for the past 20 years, and we focused on the older cohort of women [in this study] because we thought this is a population that has generally not been included in clinical tria Continue reading >>

Statin Side Effects: Weigh The Benefits And Risks

Statin Side Effects: Weigh The Benefits And Risks

Statin side effects can be uncomfortable, making it seem like the risks outweigh the benefits of these powerful cholesterol-lowering medications. Doctors often prescribe statins for people with high cholesterol to lower their total cholesterol and reduce their risk of a heart attack or stroke. While statins are highly effective, they have been linked to muscle pain, digestive problems and mental fuzziness in some people and may rarely cause liver damage. Statins include atorvastatin (Lipitor), fluvastatin (Lescol), lovastatin (Altoprev), pitavastatin (Livalo), pravastatin (Pravachol), rosuvastatin (Crestor) and simvastatin (Zocor). Having too much cholesterol in your blood increases your risk of heart attacks and strokes. Statins block a substance your liver needs to make cholesterol. This causes your liver to remove cholesterol from your blood. If you think you're experiencing side effects from statins, don't just stop taking the pills. Talk to your doctor to see if a change of dosage or even a different type of medication might be helpful. What are statin side effects? Muscle pain and damage One of the most common complaints of people taking statins is muscle pain. You may feel this pain as a soreness, tiredness or weakness in your muscles. The pain can be a mild discomfort, or it can be severe enough to make your daily activities difficult. Oddly enough, most randomized controlled studies of statins indicate that people taking statins develop muscle pain at the same rate as people taking placebo. But up to 29 percent of the people who start taking statins report muscle pain and many discontinue statins because of it. Many of these people do well when they are switched to a different variety of statin. Very rarely, statins can cause life-threatening muscle damage call Continue reading >>

What Statin Is Best For People With Diabetes?

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 >>

Statin Use Linked To Heightened Type 2 Diabetes Risk In Susceptible Individuals

Statin Use Linked To Heightened Type 2 Diabetes Risk In Susceptible Individuals

Long term use of statins to lower blood fats and stave off cardiovascular disease is associated with a 30 per cent heightened risk of developing type 2 diabetes in susceptible individuals, suggests a large study published in the online journal BMJ Open Diabetes Research & Care. The findings held true irrespective of the criteria used to determine the need for treatment, suggesting that these factors weren't major contributors to diabetes risk, say the researchers. They base their findings on 3234 participants in the US Diabetes Prevention Program Outcomes Study (DPPOS). This is a long-term follow up study to a randomised clinical trial which looked at whether modest weight loss through lifestyle changes or treatment with metformin could reduce or delay development of type 2 diabetes in people at high risk. The trial participants were given standard advice on healthy eating and exercise and were randomly assigned to either an intensive lifestyle programme, treatment with metformin, or a dummy drug (placebo). At the end of the trial they were invited to take part in DPPOS, during which their blood fats and blood pressure were measured annually. Blood glucose was measured twice a year, at which point new statin treatment was recorded. At the start of DPPOS fewer than 4 per cent of participants were taking statins, but use of these drugs gradually increased until after 10 years around a third of the participants were taking them. The most commonly prescribed statins were simvastatin (40%) and atorvastatin (37%). The likelihood of a prescription rose substantially after a diagnosis of diabetes. However, statin use was itself associated with a heightened risk of being diagnosed with diabetes, irrespective of which treatment group the participants had been in during the trial. Continue reading >>

Statins Linked To Diabetes Risk

Statins Linked To Diabetes Risk

Taking statins significantly increases the risk of developing type 2 diabetes in people already in danger of having the disease, new research shows. In a paper published in the British Medical Journal, a team of scientists led by Jill Crandall of the Albert Einstein College of Medicine in New York, US, reports that in people at high risk of developing diabetes statin use heightened the chances of doing so by 30%. To make their finding, Crandall and colleagues used data obtained during a long-running US study known as the Diabetes Prevention Program Outcomes Study (DPPOS). The DPPOS was set up initially to discover whether a combination of weight loss, exercise and diet was better than a drug called metformin at preventing the onset of diabetes in people who showed no clinical symptoms of the disease but had blood glucose levels that indicated they were at risk of developing them. The study tracked 3234 volunteers recruited through 27 treatment centres. The first tranche of results, published in 2002 in the New England Journal of Medicine, found that the exercise-diet regime was more effective than metformin. (Those taking the drug still recorded positive, albeit less pronounced, health outcomes.) These included three meta-analyses. Typical was the 2010 study published in The Lancet and led by Naveed Sattar of the University of Glasgow, Scotland, that found “statin therapy is associated with a slightly increased risk of development of diabetes, but the risk is low both in absolute terms and when compared with the reduction in coronary events”. These studies, however, had taken a wide range of statin users as their focus. Crandall and her colleagues opted instead to look specifically at people already identified as being at significant risk of developing diabetes. At Continue reading >>

Pharmacist Nudging Closes Gap In Statins For People With Diabetes

Pharmacist Nudging Closes Gap In Statins For People With Diabetes

Pharmacist nudging closes gap in statins for people with diabetes Pharmacist nudging closes gap in statins for people with diabetes JAPhA study says calls, faxes to prescribers help patients get recommended prescriptions Pharmacists who reach out to prescribers can help ensure that people with diabetes get the recommended prescriptions for statins, according to a study published online in the Journal of the American Pharmacists Association. Guidelines like the American College of Cardiology and American Heart Associations joint Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults recommend moderate- to high-intensity statins for people with diabetes between the ages of 45 and 70, yet many people in this patient population do not receive prescriptions for the drugs. Researchers in the study randomized 420 people aged 45 to 70 who had diabetes but no prescription for a statin into two groups, an intervention group (221 patients) and a control group (199 patients). Over the course of 3 months, pharmacists reached out to the intervention groups primary care prescribers with a standardized intervention message, and prescribers were welcome to initiate statin prescriptions however they wishedphone, fax, or e-prescription. The pharmacists began their intervention with phone calls. If they couldnt reach the prescriber or the prescriber didnt return messages, they sent a fax, then another fax 5 to 10 business days later if they still had no response. The pharmacists took no action regarding the control group. At studys end 46 patients (20.8%) in the intervention group had statins prescribed, compared with 17 (8.5%) in the control group. Patients in the intervention group were more likely to pick up their prescriptions as well, Continue reading >>

Statins And Diabetes | What Happens When Blood Sugar Rises?

Statins And Diabetes | What Happens When Blood Sugar Rises?

Statins and Diabetes | What Happens When Blood Sugar Rises? What happens when a prescribed medication raises blood sugar levels? Are statins and diabetes connected? What if glucose levels return to normal when statins are stopped? A few years ago three pillars of modern medicine recommended that virtually all adults with diabetes should take statin-type cholesterol-lowering drugs. This is what the American Diabetes Association stated in its New Standards of Care in 2014: all people with diabetes take either moderate or high doses of statins, in keeping with recent changes to guidelines for cardiovascular risk management enacted by the American College of Cardiology (ACC) and American Heart Association (AHA). Theres one catch with this guideline about statins and diabetes: drugs like atorvastatin, rosuvastatin and simvastatin sometimes trigger diabetes or make it harder to control blood sugar. A Reader Complains about Statins and Diabetes: Q. Statins raise blood sugar. I took them twice and both times my blood sugar got out of control. When that happened, the doctor prescribed meds for diabetes. I felt fine without the drugs, but the medicines made me feel sick. The answer was to take more meds, both the statin and the diabetes drugs. Am I really a diabetic if my blood sugar is high only when I am taking a statin? A. You raise a fascinating question. Most experts in cardiology and metabolic disorders insist that all patients with diabetes should be on statins. We often read articles that begrudgingly admit that statins may slightly raise blood sugar levels. The specialists suggest, however, that this is not that big a deal. Any elevation in blood sugar is theoretically outweighed by the overwhelming benefits of statins. A connection between statins and diabetes should, Continue reading >>

Statins Increase The Risk Of Developing Diabetes In At-risk People

Statins Increase The Risk Of Developing Diabetes In At-risk People

Among susceptible individuals, statins — which are a common cholesterol-lowering medication — could increase the risk of type 2 diabetes by 30 percent. These new findings are sure to reignite debate. Statins lower cholesterol by reducing its production in the liver. They do this by blocking an enzyme called hydroxy-methyl-glutaryl-coenzyme A reductase, which is involved in its manufacture. Statins are one of the most widely prescribed types of drug in the United States. Between 2011 and 2012, over a quarter of U.S. adults over the age of 40 were taking cholesterol-lowering medication. The vast majority of these drugs were statins. Alongside their cholesterol-lowering ability, statins also have positive effects on inflammation and oxidative stress. Taken together, it would be unsurprising if statins helped to reduce the risk of developing diabetes. But the reverse may well be true. Evidence is mounting that long-term statin use could increase the risk of type 2 diabetes. The first study to mention this potential effect was published in 2008. Between then and now, many meta-analyses have been carried out. Some have added evidence supporting a link between statin use and type 2 diabetes, while others have brought such a link into question. Therefore, a definitive answer is yet to be found. Reopening the statin-diabetes debate Many previous studies that pointed out a link did not specifically set out to investigate diabetes and statins; their prime focus was on cardiovascular events. Because the number of diabetes cases within the experimental groups was low, it was difficult to get a good understanding of the associated risks. So, to take a fresh look at this interaction, researchers from the Albert Einstein College of Medicine in New York City, NY, decided to focus th Continue reading >>

American Diabetes Association Indications For Statins In Diabetes

American Diabetes Association Indications For Statins In Diabetes

Is there evidence? INTRODUCTION The American Diabetes Association (ADA) standards of care for diabetes state that statin therapy should be initiated in individuals with diabetes and other cardiovascular risk factors with a target LDL cholesterol of <100 mg/dl. Furthermore, a possible target LDL of <70 mg/dl is stated in patients with diabetes and cardiovascular disease. In this mini-review, we examine the evidence that exists regarding LDL cholesterol–based treatment goals in individuals with diabetes. From our review of the current literature, it is evident that the majority of clinical trials were designed using a fixed dose of statins and not in an LDL cholesterol–based “treat-to-target” approach (thus differing from the common design of blood glucose control trials). This leads us to reassess the current guidelines with special emphasis on the very-low-risk and very-high-risk individuals with diabetes, where the evidence is less robust. We conclude that in this subset of individuals with diabetes, statin therapy should be based on the existing evidence and prescribed in a fixed-dose manner. Published yearly, the ADA standards of clinical care portray the principle guidelines of diabetes care based on the constantly evolving body of evidence for the treatment of patients with diabetes. The 2008 standards of care state the following for statin use in diabetic individuals (1): Statin therapy should be added to lifestyle therapy, regardless of baseline lipid levels, for diabetic patients a) with overt cardiovascular disease (CVD) (A: level of evidence as described in the ADA evidence-grading system [Table 1]); the primary goal is an LDL cholesterol <100 mg/dl (<2.6 mmol/l) (A); a lower LDL cholesterol goal of 70 mg/dl (1.8 mmol/l), using a high dose of a statin, Continue reading >>

The New 2017 American Diabetes Statement On Standards Of Medical Care In Diabetes: Reducing Cardiovascular Risk In Patients With Diabetes

The New 2017 American Diabetes Statement On Standards Of Medical Care In Diabetes: Reducing Cardiovascular Risk In Patients With Diabetes

The New 2017 American Diabetes Statement on Standards of Medical Care in Diabetes: Reducing Cardiovascular Risk in Patients With Diabetes The new 2017 American Diabetes Association (ADA) Standards of Medical Care in Diabetes contains recommendations for the management of diabetes and its complications.1 The ADA statement has been updated based on the recent evidence regarding diabetes care and reiterates the focus on the control of traditional modifiable cardiovascular disease (CVD) risk factors through lifestyle and pharmacological interventions. These ADA evidenced-based recommendations for using pharmacological agents to treat risk factors are useful for minimizing CVD risk, taking into consideration the risk-benefit of treatments. In this article, we briefly discuss how the ADA recommendations can help with the management of CVD risk factors among individuals with diabetes. The ADA recommendations place substantial emphasis on the role of lifestyle modifications, including diet and physical activity, for achieving better glycemic control and cardiovascular outcomes. Prior studies have shown that dietary factors influence mealtime insulin dosing and blood glucose levels. High protein (20-30%) and low carbohydrate diet can have salutary effects on fasting blood glucose, postprandial glucose, and insulin response.2 There is no evidence that low protein intake below the recommended daily allowance (0.8 g/kg body weight/day) can delay the reduction in glomerular filtration rate.3,4 Therefore, as part of individualized medical nutrition therapy, carbohydrate, fat, and protein counting should be used to guide flexible insulin therapy. The recent ADA statement has also made separate recommendations for exercise and physical inactivity as two measures of lifestyle behavior. Continue reading >>

Statins Linked To Raised Risk Of Type 2 Diabetes

Statins Linked To Raised Risk Of Type 2 Diabetes

HealthDay Reporter WEDNESDAY, March 4, 2015 (HealthDay News) -- Cholesterol-lowering statin drugs may significantly increase a person's risk of developing type 2 diabetes, a new study from Finland suggests. Researchers found that statins were associated with an almost 50 percent higher risk of developing type 2 diabetes, even after adjusting for other factors. Statins appear to increase the risk of type 2 diabetes in several ways, the researchers said. One is that the drugs can increase a person's insulin resistance, and the other is that the cholesterol-lowering drugs seem to impair the ability of the pancreas to secrete insulin, according to the report. Commenting on the study, Dr. Ronald Goldberg, director of the Lipid Disorder Clinic and associate director of the Diabetes Research Institute at the University of Miami, said the researchers "show evidence that statins increased insulin resistance, and that the people who developed diabetes appeared to have less ability to respond to the insulin resistance by making more insulin." The study authors noted, however, that their research only found an association between statin use and diabetes risk. And since the study was limited to white men, it's not clear if the findings would apply to women or other racial groups. More than 29 million people in the United States have diabetes, according to the American Diabetes Association (ADA). Type 2 diabetes occurs when the body becomes resistant to insulin, a hormone needed to process the sugars found in foods. To compensate, the body produces more insulin. Excess weight and a sedentary lifestyle are two important risk factors for type 2 diabetes, according to the ADA. Prior studies have indicated that statins may increase a person's risk of diabetes, the authors said in backgro Continue reading >>

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