Study shows statins increase risk of diabetes by 38%

Study shows statins increase risk of diabetes by 38%

As of 2018, 34.1 million American adults were living with diagnosed or undiagnosed diabetes, according to a 2020 U.S. Department of Health and Human Services study. Men and non-Hispanic white individuals represented the majority of these diabetes cases.

Just two years later, the number of adults with diagnosed and undiagnosed diabetes rose to 37.3 million, according to the Centers for Disease Control and Prevention. Additionally, 96 million people ages 18 and older are prediabetic, representing 38% of the American adult population.

These data suggest that diabetes has reached epidemic proportions in the United States. A study published in the British Journal of Clinical Pharmacology found that adults who take statins to regulate cholesterol levels have an increased risk of developing insulin resistance and type 2 diabetes compared to the general population. However, no concrete evidence has been found linking high cholesterol to the risk of cardiovascular disease.

As explained in previous articles, three factors significantly influence the risk of cardiovascular disease and are often related to each other. These factors are insulin resistance, chronic inflammation and elevated iron levels. Unfortunately, conventional medicine tends to overlook these factors in the prevention and treatment of cardiovascular disease.

Statins, or cholesterol-lowering medications, are the primary treatment strategy in Western medicine and are often considered the most cost-effective medication. Dr. Malcolm Kendrick, a general practitioner in Cheshire, England, and author of three books, including "Statin Nation: Damaging Millions in a Brave New Post-Health World," estimates that the pharmaceutical industry has made over $1 trillion from statins.

Statins increase diabetes risk by 38%

A study published in the British Journal of Clinical Pharmacology by a team at Erasmus University Medical Center in the Netherlands showed a link between statin use and diabetes. The study focused on blood sugar characteristics associated with type 2 diabetes.
The Rotterdam study included 9,535 non-diabetic participants. Over 15 years, they discovered that statin users had higher fasting serum insulin concentrations and greater insulin resistance than non-users.

This resulted in a 38% increased risk of developing type 2 diabetes. The researchers concluded that statin users may be at increased risk of developing hyperglycemia, insulin resistance and, consequently, type 2 diabetes. Preventive strategies such as maintaining blood sugar levels and losing weight when starting statin therapy could help reduce the risk of diabetes.

The specific mechanism by which statins induce type 2 diabetes remains unknown and may not be related to obesity. Scientists have identified a condition called normal-weight metabolic obesity (MONW), which is a subset of the population that develops insulin sensitivity and an increased risk of diabetes despite being of normal weight.

Recent research has also found that people who take statins have a higher risk of developing type 2 diabetes. Scientists have suggested several reasons for this increased risk, including insulin sensitivity and reduced insulin secretion from the pancreatic beta cells. An article published in the International Journal of Molecular Science examined the mechanisms by which statins appear to increase risk, including the effects of differential microRNA expression on epigenetics.

Another study compared DNA methylation in statin users with that in non-users and concluded that DNA methylation contributes to the effect of statins on insulin traits.

Statins also increase the risk of cardiovascular events

A third retrospective cohort study analyzed the results of 13,698 patients divided into statin and non-statin users. The study began in 2005, with participants initially free of atherosclerotic cardiovascular disease or diabetes. They followed the group until 2013 and assessed the risk of type 2 diabetes. The results showed that statin users had a higher risk of developing new type 2 diabetes compared to non-statin users. Researchers separated risk by different statin drugs and found that five years of taking simvastatin (Zocor) followed by atorvastatin (Lipitor) was associated with increased risk.
At the height of the pandemic in January 2021, a study published in the journal Atherosclerosis found that people taking statins had a higher rate of cardiovascular events. This finding is notable because statins are thought to reduce the frequency of such events.

The researchers used a coronary artery calcium score (CAC), a noninvasive CT scan to detect plaque buildup in the coronary arteries. This score, also called the cardiac calcium score, bone scan or Agatston score, is generally used to calculate the risk of developing coronary artery disease. The researchers hypothesized that statins might increase calcification and sought to examine the significance of predicting CAC levels when using statins.

They compared 28,025 patients ages 40 to 75 who were taking statins, and about 11 months after the results were published, Tucker Goodrich plotted the raw data. Only at the higher CAC scores of 400 or more were the data nearly identical between statin users and nonusers. Otherwise, cardiovascular events occurred more frequently in statin users than in non-users.

The researchers concluded: "CAC score remains a risk predictor in statin users, and the changing relationship between CAC density and outcome may explain the weaker relationship between CAC and outcome in statin users."

The researchers admitted that only a baseline CAC value was known, so they could not assess whether statins affect the progression of calcification. The values ​​ranged from zero to over 400, with zero representing no plaque and a lower risk of heart attack, 100 representing patients with mild heart disease and moderate risk of heart attack, and the range from 101 to 400 representing moderate amounts of plaque that could block a coronary artery.

Type 2 diabetes predicted in adolescents...

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Type 2 diabetes in adolescents is expected to increase by almost 700% by 2060

Despite the raw data, some have suggested that patients should have more than one CAC score despite being exposed to the same radiation as ten X-rays because the information could skew study results to show that statins had some benefits and reduced calcified plaque. However, this did not change the figures showing that people who took statins died at higher rates than those who did not take them.

False evidence increases pharmaceutical profits

In a 2018 peer-reviewed story titled, “Statin Wars: Have We Been Misled About the Evidence?” Maryanne Demasi, Ph.D., an investigative health reporter published in the British Journal of Sports Medicine, addresses some of the controversy.
Although access to Demasi's article requires a fee, she tests her arguments in a presentation at the University of Sydney. Among them is the claim that the “statin empire” is based on prescribing these drugs to people who don't necessarily need them and are likely to experience side effects without benefit.

Several outlandish recommendations have been proposed, such as prescribing statins to everyone over 50 regardless of cholesterol levels, testing and setting dosages for young children, and even adding statin drugs to fast food or municipal water supplies.

Doctors are now divided into two camps: those who advocate for statins to be life-saving and safe for everyone, and those who believe they are unnecessary and harmful. Such a gap arises even though everyone has access to the same research results and data.

Demasi suggests that economic aspects need to be taken into account to understand this gap. The cost of developing and marketing a new drug is over $2.5 billion. “The best way to increase company profits is to expand the indications of an existing drug,” she says, and that’s exactly what happened with statins.

After redefining “high cholesterol,” the pharmaceutical industry vastly expanded the patient population for statins. Today, it is not uncommon for people whose cholesterol levels were considered normal a few decades ago to be prescribed statins.

Additionally, Demasi highlights the selective reporting of trial data by pharmaceutical companies. Many studies report only relative risk reductions, which sound more impressive than absolute risk reductions. For example, a drug that reduces the risk of a heart attack from 2% to 1% within five years can be said to reduce the risk by 50% (relative risk reduction) or by 1% (absolute risk reduction). The former sounds far more impressive, even if the two numbers describe the same result.

She also mentions the problem of publication bias. Negative studies, or those showing no benefit or potential harm from statins, are published less often than those showing positive effects. This distorts the overall understanding of the effectiveness and safety of statins.

Reassessing the role of statins

Given the potential side effects and mixed evidence regarding their effectiveness, some doctors and researchers have begun to question the widespread use of statins. The focus on lowering cholesterol may be misplaced, they argue, since half of people who have a heart attack have normal cholesterol levels.

Instead of focusing on cholesterol levels, these critics suggest, doctors should pay more attention to inflammation, which plays a key role in heart disease. Lifestyle changes such as eating a healthier diet, exercising regularly, and reducing stress can effectively reduce inflammation without the need for medication.

The debate over statins is far from settled. However, it is clear that prescribing these medications requires a careful, individualized approach that takes into account each patient's individual risk factors and circumstances. As always, patients should be fully informed of the potential benefits and risks of any medication they are considering.

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