Authors led by Ishak Mansi, M.D. from the department of medicine, Veterans Affairs (VA) North Texas Health System in Dallas reported their findings in the Journal of General Internal Medicine which revealed that statin (a drug primarily used to prevent cardiovascular diseases) use increases the risk for diabetes, diabetes complications, and obesity in a new retrospective cohort study. It involved tracking of individuals in a database for an average of 6.5 years.
“Whereas the increased risk of diabetes with statins is well-known, the increased risk of diabetic complications has not been previously described. The risk of diabetes with statins has been known, but until now it was thought that this might be due to the fact that people who were prescribed statins had greater medical risks to begin with,” said Dr. Mansi in a VA statement.
According to the research team, further studies are still needed to prove the risk or benefit of the use of statins for primary prevention for cardiovascular diseases. They stressed out that there is missing information relating to the parameters of the disease. Also, a comment from Dr. Alvin Powers, director of Diabetes division, endocrinology, and metabolism at Vanderbilt University in Tennessee.
“I think the risk/benefit ratio in people with diabetes and statins remains the same as it was before, and the recommendations per the American Diabetes Association still are relevant. (The study) confirmed (an) increased risk for diabetes, and in this case, there were more complications of diabetes in the group taking statins, but it’s not clear if that is a result of the statins or just the patient population.”
However, contrary to what Dr. Powers said, another recent study conducted by Dr. Markku Laakso of the University of Eastern Finland and Kuopio University urged everyone to take caution when using statins as a primary prevention. Dr. Laakso added that statins are not for everybody; this is mostly relevant to women, who are at a lower risk of getting cardiovascular disease.
Here are the results of the study led by Dr. Mansi:
The team noted that there has not been an adequate study on individuals who are on a primary-prevention population and the long-term effect of statins on their health conditions. Although statins has long been linked to diabetes, doctors always tell patients that the drug’s benefit outweighs this risk. These figures might help you in considering about using statins. (Shared by Medscape)
Dr. Mansi and the team identified Tricare beneficiaries who were evaluated between October 1, 2003 and March 1, 2012 and divided individuals into a group of statin users and a group of nonusers; about 75% of the statin prescriptions were for the drug simvastatin.
The researchers excluded those who had preexisting cardiovascular disease, diabetes, or any life-limiting chronic diseases at baseline and used 42 baseline characteristics to generate a propensity score to match statin users and nonusers. Of a total of 25,970 healthy adults at baseline, the researchers’ propensity score matched 3351 statin users and 3351 nonusers.
The overall proportion of patients who developed diabetes during the follow-up period was approximately 14%, which is similar to recent national trends, the researchers say.
After adjustment for confounding factors — including the fact those who used statins had more visits with healthcare providers than nonusers — those who took statins still had an 85% higher risk of developing new-onset diabetes (odds ratio [OR], 1.85) and more than double the risk of diabetes with complications (OR, 2.53), as well as in increase in overweight/obesity (OR, 1.12) compared with those who didn’t take statins.
The results also show that high-intensity statin therapy was associated with the highest risk of diabetes, diabetic complications, and overweight/obesity (adjusted ORs 2.55, 3.68, and 1.58, respectively), thereby demonstrating a dose-response relationship.
The research team led by Dr. Mansi found out that statin use is indeed, associated with a “very high risk of diabetes complication which was never shown before.” But the team noted that their findings will need to be apprehended by other studies for their implications might be different. Also, they added that decades of statin use for primary prevention is inappropriate and needs to become a part of the assessment for risk/benefit for statin can affect the overall comorbidity, aside from cardiovascular morbidity.
“I myself am a firm believer that these medications are very valuable for patients when there are clear and strict indications for them. But knowing the risks may motivate a patient to quit smoking, rather than swallow a tablet, or to lose weight and exercise. Ideally, it is better to make those lifestyle changes and avoid taking statins if possible” says Dr. Ishak Mansi.
Diet and exercise are the two constant variables when it comes to health and wellness. It is indeed easy to swallow a tablet but it is more important to get yourself informed about the complications certain drugs can do to your body. Get yourself informed today.