Cholesterol lowering drugs may be linked to diabetes

You may have concerns about taking a cholesterol-lowering statin drug, such as atorvastatin (Lipitor and generic), rosuvastatin (Crestor), and simvastatin (Zocor and generic), after a recent study linked these drugs to an increased risk of type 2 diabetes. But Consumer Reports Best Buy Drugs experts say the heart-protecting benefits of statins generally outweigh on diabetes risk, so don’t skip a statin if you need it to lower your cholesterol.

Diabetes is not a new side effect of statins. The Food and Drug Administration added it to the label of all statins in 2012 based on a review of studies that found a slightly elevated risk. For example, a study that reviewed 13 randomized, controlled clinical trials of statins found that 4.9% of people who took one of the drugs for 4 years developed diabetes, compared to 4.5% of those who did not take a statin.

Lower cholesterol versus higher blood sugar

The new study, published in the Journal of General Internal Medicine, raises questions about whether the risk of diabetes is higher than previously thought. The researchers looked at medical data from nearly 7,000 men and women with an average age of 53. About 31% of those who took a statin for an average of 5.5 years developed diabetes, compared with 19% of those who did not.

But because the study was not a randomized, controlled study — the gold standard for determining whether a drug causes a particular side effect — it’s unclear whether the rise in diabetes was entirely due to statins. Study participants may have had other factors that contributed to the development of diabetes.

“All we can say,” says Ishak Mansi, MD, internist at Veteran’s Hospital of North Texas and co-author of the study, “[is] than in the selected healthy population…the risk of diabetes after prolonged follow-up was higher than expected.”

The risk of diabetes with statins is relatively small and is likely outweighed by the potential benefits of medications to lower LDL or “bad” cholesterol levels and prevent a heart attack or stroke, says Paul Thompson, MD, chief of cardiology at Hartford Hospital in Connecticut. Previous research found that for every case of diabetes triggered, statins prevented at least three heart attacks or other serious heart problems, Thompson adds.

“The bottom line is that the low risk of developing type 2 diabetes should not deter you or influence your decision to use a statin if indicated,” says Marvin M. Lipman, MD, Chief Medical Advisor of Consumer Reports.

To find out if a statin is right for you, our Best Buy Drug report on statins recommend to use this calculator. It estimates your overall risk of heart attack or stroke over the next 10 years based on your total cholesterol, HDL “good” cholesterol, age, blood pressure, and whether you smoke or have diabetes.

Our medical advisers say that for some people at low risk of heart attack or stroke– less than 10% over the next 10 years – diet and lifestyle changes should be the first step in lowering cholesterol. This includes adopting a Balanced diet that is low in saturated fat, trans fat and cholesterol, and making lifestyle changes such as exercising and losing weight if you need to or quitting smoking if you are a smoker.

These changes could lower your LDL and your risk of heart attack and stroke low enough that you don’t need to take a statin. Or, if you are already taking a statin, these changes may allow you to stop your treatment or reduce your dose, which in turn may reduce your risk of side effects.

Our medical advisors also recommend that you use the calculator to determine how much taking a statin would reduce your risk. And talk to your doctor. You may find that lowering your cholesterol with a statin won’t make much of a difference to your risk of heart attack or stroke over 10 years. If so, skip it.

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