Elderly Women at Higher Risk of Developing Diabetes While Taking Statins
The risks may be outweighing the benefits, but only to a point.
Statins, the inhibitors of HMG-CoA reductase, have long been an important piece in the prevention and treatment of atherosclerotic cardiovascular disorders. By reducing production of low-density lipoprotein cholesterol (LDL-C), the risk of developing cardio- and cerebrovascular events has been significantly reduced in patients with and without diabetes. Statins are fairly well tolerated, with the major use limiting side effect being myalgias, which are largely associated with increases in statin dosage and potency, as well as prolonged periods of use. Since the discovery and increased use of statin therapy, development of diabetes has also been linked to their use, in varying degrees.
Several studies over the years have proposed mechanisms by which statins promote diabetes, including decreasing insulin secretion and insulin sensitivity, but the consensus remains open. This could be due to variation among the class itself. For example, pravastatin has been shown to be less likely to cause diabetes than the other statins, whereas atorvastatin, simvastatin, and rosuvastatin have the most profound effects on insulin secretion and sensitivity. It is not surprising that the mid- to high-range doses of atorvastatin and rosuvastatin are considered to be high potency, carrying the largest effect on lowering LDL-C, with higher dose simvastatin being moderate potency. Further clouding the issue is the finding that the most dramatic reduction of insulin sensitivity occurred in patients who were normoglycemic, suggesting th Continue reading