It is currently estimated 12% of the Canadian population (ages 20-80) is on a statin drug. These commonly prescribed medications are used to lower your LDL-cholesterol. By lowering one’s LDL-cholesterol, these drugs can lower your risk of dying from a cardiovascular related incident (ie heart attack or stroke).
Statins are a favoured drug for lower cholesterol because they generally come with less side-effects, are considered a safer option, and have some additional benefits, such as lowering inflammation. For these reasons they are generally considered a superior option, relative to other prescription medications.
Even though statins are generally safer and more effective than other drug options, there are recent studies showing there are more risk associated with them than previously thought. Many studies have found that statin use is associated with an increased risk of developing diabetes, or complicating existing diabetes. Considering diabetes is a huge risk factor for developing advanced cardiovascular disease AND approximately 7% of the population already has diabetes, this is a massive concern.
One study looked at 3351 statins users and 3351 nonusers to evaluate whether or not statins can negatively affect your blood sugars. They found that patients were approximately 2X as likely to get new-onset diabetes if they were on a statin and 2.5X as likely to have diabetic complications, if they were already diabetic.
Another study (a meta-analysis) concluded that the increased risk of statin-induced diabetes was 9-13%! What they have also found is that women, the elderly and anyone on a high dose appear to be at the highest risk when it comes to developing these adverse effects.
This then lends itself to the question: Do the benefits outweigh the cost? Many would argue yes, the reduction in cardiovascular risk outweighs the risk of developing, or worsening, diabetes.
For example, one study suggested that because statins can slow the development of a fatty liver (a condition that can be a consequence of diabetes) the benefits are equal to the risk. The problem is that there is no clear yes-or-no answer in the literature. The relationship between statin therapy and diabetes has just recently been accepted by the medical community so more time will be needed to better understand the benefit-cost ratio.
If you’re currently in a place where your risk of cardiovascular disease isn’t high, you may want to play with your options before committing to drug therapy. Lifestyle changes, such as diet and exercise, provide a much greater benefit without the risk of diabetes. Just remember that statins are a good option for lower cholesterol but, they are not your only option.
Take aways:
1) You should ensure your doctor has screened you for diabetes BEFORE you go on a statin. This is likely being done, but it is worth asking, just to be safe. This also means blood sugars should be monitored while you are on the medication.
2) The higher the dose of statin, the higher the risk for blood sugar problems. If there are ways to lower your dose, safely, then they should be done. This is a discussion that needs to be had with your healthcare provider.
3) Because this is such a commonly prescribed medication you want to make sure that there is good evidence for why you are being put on this medication. Studies have shown that this particular medication is often given without sufficient reasons. Make sure your doctor has explained why you are on this medication ie Is your cholesterol the only elevated risk factor you have? How elevated is it? Were you told your options?
4) If you and your doctor are unsure on whether or not the risk outweigh the benefits you definitely want to talk about lifestyle modifications, or supplemental therapy, you can do instead of drug therapy to lower your risk of cardiovascular disease. These should always be done first, as they can prevent your from needing to go on drug therapy in the first place.
If you would like to learn more about your alternative options to statin therapy or things you can do to offset the risk associate with statins, please book in with a naturopathic doctor who is well versed in this topic.
Disclaimer
Information can be empowering, but we all have unique health profiles and needs. The health-related information contained in this article is intended to be general in nature and should not be used as a substitute for a visit with a licensed naturopathic doctor. The advice in this article is not intended to provide medical advice, diagnosis or treatment.
References
1) Aiman, U., Najmi, A., & Khan, R. A. (2014). Statin induced diabetes and its clinical implications. Journal of pharmacology & pharmacotherapeutics, 5(3), 181.
2) Casula, M., Mozzanica, F., Scotti, L., Tragni, E., Pirillo, A., Corrao, G., & Catapano, A. L. (2017). Statin use and risk of new-onset diabetes: A meta-analysis of observational studies. Nutrition, Metabolism and Cardiovascular Diseases, 27(5), 396-406.
3) Mansi, I., Frei, C. R., Wang, C. P., & Mortensen, E. M. (2015). Statins and new-onset diabetes mellitus and diabetic complications: a retrospective cohort study of US healthy adults. Journal of general internal medicine, 30(11), 1599-1610.
4) Johansen, M. E., Gold, K. J., Sen, A., Arato, N., & Green, L. A. (2013). A national survey of the treatment of hyperlipidemia in primary prevention. JAMA internal medicine, 173(7), 586-588.