Advice on Statins and their known risk in increasing Diabetes and Diabetic Insulin Resistance

[Jan1956]

There is a lot of research on the internet about the link between taking Statins and an increased risk in developing diabetes and insulin resistance .
One of statins mentioned is Atorvastatin and the risk apparently increases if it’s taken at high density 40 mg to 80mg . I take Atorvastatin 40mg and I’ve been wondering what to do having recently developed diabetes. I’ve been bordering on and under prediabetes for the last decade and always managed it but when I look back has my increase in Statins meds tipped me over the edge? Hba1c is 55
Statins have certainly helped my Cholesterol which is now middle of the normal range.i was taking 20mg and had reasonable cholesterol control but GP decided to increase to 40 mg about 18 months ago to give levels a final blast

Apparently Simvastatin may have a lesser risk - - but then I assume only at lower levels?.

I’ve also read that it can be very dangerous to stop statins as other factors ie due to its effect on the liver, in addition to other things eg high cholesterol would then expose you to other more serious heart / liver related issues?

Certainly, the idea of going cold turkey is out of the question and even reducing it seems to be have no back up research on whether this then can then revert any diabetes damage caused - like it does when lowering diabetes with diet and exercise etc.

it’s a question I’m going to ask my GP - i think I may be ready to reduce Atorvastatin back to 20mg but I’m not hopeful of an informed answer as GP herself says she’s no expert - I’d like to ask this question to a diabetes consultant but I don’t have one lol.

Just wondering if this is something that any of the group have any knowledge of , or have found out from a specialist ? - if you are lucky enough to have a diabetes specialist.

Thank you.

 

[everydayupsanddowns]

I’m not sure anyone here is qualified to give you an answer unfortunately @Jan1956

Instinctively it feels like with such a long period at risk of diabetes, your body has been struggling to manage glucose levels for a while. That in its turn can increase your risk of an adverse cardiac event, and statins have lots of high quality evidence of their effectiveness in reducing risk of heart disease and stroke.

You could have gone on to develop diabetes even if you hadn’t been taking statins at all (that’s happened to many on the forum in the past).

But of course all of this is risk, and risk reduction - not certainty.

There is some evidence that statins can raise glucose levels in some people, but I think the overall balance of benefits vs possible harms still lands on the side of their benefits in terms of heart disease risk reduction from the majority of the evidence.

Claim and counterclaim about statins and “what the research clearly shows” seems to be a bit of a murky swamp, to be honest. I think things are often more complex and nuanced than some writers / bloggers / commentators would suggest.

 

[helli]

One thing to remember is that increased blood glucose is a risk. It is not a certainty.
I have been taking a low dose of statins for a few months with no increase in BG.

 

[Tdm]

Can't say going on statins made any difference to by blood sugars/insulin sensitivity

 

[silver minion]

My doctor recommended statins 18 months ago after a routine well women check showed my cholesterol level was a bit high. As it wasn't much over recommended levels I agreed with GP to manage it with diet and exercise alone and review in 6 months. At review cholesterol levels had reduced. No statins needed however it didn't stop me getting diabetes

 

[harbottle]

There is a lot of research on the internet about the link between taking Statins and an increased risk in developing diabetes and insulin resistance .
One of statins mentioned is Atorvastatin and the risk apparently increases if it’s taken at high density 40 mg to 80mg . I take Atorvastatin 40mg and I’ve been wondering what to do having recently developed diabetes. I’ve been bordering on and under prediabetes for the last decade and always managed it but when I look back has my increase in Statins meds tipped me over the edge? Hba1c is 55
Statins have certainly helped my Cholesterol which is now middle of the normal range.i was taking 20mg and had reasonable cholesterol control but GP decided to increase to 40 mg about 18 months ago to give levels a final blast

Apparently Simvastatin may have a lesser risk - - but then I assume only at lower levels?.

I’ve also read that it can be very dangerous to stop statins as other factors ie due to its effect on the liver, in addition to other things eg high cholesterol would then expose you to other more serious heart / liver related issues?

Certainly, the idea of going cold turkey is out of the question and even reducing it seems to be have no back up research on whether this then can then revert any diabetes damage caused - like it does when lowering diabetes with diet and exercise etc.

it’s a question I’m going to ask my GP - i think I may be ready to reduce Atorvastatin back to 20mg but I’m not hopeful of an informed answer as GP herself says she’s no expert - I’d like to ask this question to a diabetes consultant but I don’t have one lol.

Just wondering if this is something that any of the group have any knowledge of , or have found out from a specialist ? - if you are lucky enough to have a diabetes specialist.

Thank you.

There's one liver measurement that has to be taken into account with statins (Can't recall which one!) as statins can raise it, so they like it be normal.

 

[goodybags]

Ive never before heard that taking statins can increase the risk of Diabetes
but I know many people don’t like or agree to taking statins for various reasons.

by coincidence I did recently ask my Diabetic Consultant the question do I really need to take statin I take the same as you @Jan1956 (40mg every day, although I no longer have high cholesterol)
the constant said he would ask my GP to calculate two things,cardiovascular risk (QRISK2)
and secondly my FIB score, as previously I did have Fatty Liver.
A few days ago I noticed in the NHS app my QRISK2 score is now there, so will be speaking to my GP about that next time we review my Meds, my QRISK2 score is still quite high (a quick search online shows
10% or higher is considered abnormal) OK my cholesterol might be normal, but my QRISK2 score is showing as 22.5% so thinking I will benefit from the statin.

I’ve just noticed your reply to the original post @harbottle it is probably the FIB score you were thinking of
I wouldn’t be remembering about FIB or QRISK2’s usually but I’ve only this morning re-read the letter my consultant sent

 

[s'nic]

Like silver minion I refused statins, managed it using diet & exercise (also used cholesterol drink) for 6 months and doc was happy with the reduced cholesterol.

As others have pointed out, with an extended prediabetes you may have been sliding towards a diabetes diagnosis regardless of statins.
The choice to take meds or not is yours, but it is good to speak to the doc and ensure you have all the facts you need before making a decision.
Also you need to be confident that you will put (and keep) changes in place to manage cholesterol if declining statins.

 

[pjgtech]

Theres is info on here, see link, but no specific research.

Statins and Diabetes - Uses and Side Effects

Statins are a type of medication that help to lower your bad cholesterol. If you live with diabetes, then you might be prescribed a statin to lower your risk of heart attack and stroke.

www.diabetes.org.uk

 

[Bubbleblower]

Theres is info on here, see link, but no specific research.

Statins and Diabetes - Uses and Side Effects

Statins are a type of medication that help to lower your bad cholesterol. If you live with diabetes, then you might be prescribed a statin to lower your risk of heart attack and stroke.

www.diabetes.org.uk

Here are a few studies:

Effect of Statins on Fasting Plasma Glucose in Diabetic and Nondiabetic Patients
We identifified 345,417 subjects who met the criteria for inclusion in the study. Of these, 69,083 (20.0%) were statin users. Diabetes mellitus was prevalent in 6% of patients. The mean increase in FPG in patients with diabetes was 10 mg/dL (34,4%) greater in statin users versus nonstatin controls.

Effects of Statins on Skeletal Muscle: A Perspective for Physical Therapists
mean CK concentrations were 62% and 77% higher 24 and 48 hours after treadmill exercise in subjects who received lovastatin versus those who received a placebo, respectively. (CK = creatine kinase, an indication of muscle damage).

Statins Promote Interleukin-1β–Dependent Adipocyte Insulin Resistance Through Lower Prenylation, Not Cholesterol
Statins impaired insulin action at the level of Akt/protein kinase B signaling in mouse adipose tissue.

Statins exacerbate glucose intolerance and hyperglycemia in a high sucrose fed rodent model
Chronic treatment with atorvastatin made the animals hyperglycemic and glucose intolerant in comparison with diet alone.

 

[Eddy Edson]

Theres is info on here, see link, but no specific research.

Statins and Diabetes - Uses and Side Effects

Statins are a type of medication that help to lower your bad cholesterol. If you live with diabetes, then you might be prescribed a statin to lower your risk of heart attack and stroke.

www.diabetes.org.uk

This is a big metastudy, published earlier this year: https://www.thelancet.com/journals/landia/article/PIIS2213-8587(24)00040-8/fulltext

The BG impact of statins is small. Eg: In participants without baseline diabetes, mean glucose increased by 0·04 mmol/L with both low-intensity or moderate-intensity (95% CI 0·03–0·05) and high-intensity statins (0·02–0·06)

As is usual for these studies, conclusion is that modest BG increases are not very important compared to the benefits.

Interpretation​

Statins cause a moderate dose-dependent increase in new diagnoses of diabetes that is consistent with a small upwards shift in glycaemia, with the majority of new diagnoses of diabetes occurring in people with baseline glycaemic markers that are close to the diagnostic threshold for diabetes. Importantly, however, any theoretical adverse effects of statins on cardiovascular risk that might arise from these small increases in glycaemia (or, indeed, from any other mechanism) are already accounted for in the overall reduction in cardiovascular risk that is seen with statin therapy in these trials. These findings should further inform clinical guidelines regarding clinical management of people taking statin therapy.

 

[Eddy Edson]

Think it's worth pointing out that a couple of points shift in your HbA1c is clinically meaningless. If you go from 47 to 49, say, it makes zero difference to your health, even though you've crossed the bureaucratic line separating "at risk" from "diabetic". You haven't changed from "well" to "diseased", except in that bureaucratic sense.

 

[Bubbleblower]

Think it's also worth pointing out the above study was based on "analyses funded by the pharmaceutical industry".

The analysis I quoted was based on data from 345,417 patients (mean age 61 ± 15 years, 94% males, 6% diabetic, 20% statin users) from the Veterans Affairs VISN 16 database.

Just numbers, no politics, no dog in the fight, no shareholders interests.

 

[Drummer]

Atorvastatin blasted my memory.
I had a photo on the dresser with 'Mum is the one on the right' - or was it the left.
Now, almost eight years later I am beginning to be able to sing without the words again.
Coupled with all the aches and pains and the consequences of Metformin - if not taking it shortens my life I'm fine with it. Sitting staring out of the window in a care home isn't being alive in my book.

 

[indio02]

[Atorvastatin] Coupled with all the aches and pains and the consequences of Metformin

When diagnosed with T2 in March last year was prescribed metformin and 20mg of Atorvastatin as my LDL was 3.8 (under 3.4 is the aim) HDL is fine.
Thing is within 6 months I was noticing muscle & joint pain not agony but definitely noticeable. Had my HbA1c test on Thursday and am expecting the results tomorrow. Will be booking an appointment to speak to the Dr.
Does anyone have any advice on how I should play this? I'm seriously thinking of coming off the statins as the joint muscle pain is an issue and there's a worry it might get worse.
Thanks

 

[helli]

Ive never before heard that taking statins can increase the risk of Diabetes

I do not believe statins increase the risk of diabetes.
The risk is, if you have diabetes stains may increase your BG. I assume, this would also be relevant if you have prediabetes.
If you do not have diabetes, your pancreas will react to any potential increase by releasing insulin, just as it does with Dawn Phenomenon for people without diabetes.

 

[helli]

Does anyone have any advice on how I should play this? I'm seriously thinking of coming off the statins as the joint muscle pain is an issue and there's a worry it might get worse.

Yes, talk to your doctor about it.
There are different types of statin to try if you need them.

 

[goodybags]

I do not believe statins increase the risk of diabetes.
The risk is, if you have diabetes stains may increase your BG. I assume, this would also be relevant if you have prediabetes.
If you do not have diabetes, your pancreas will react to any potential increase by releasing insulin, just as it does with Dawn Phenomenon for people without diabetes.

also maybe someone who has a higher Hba1c might have already other health concerns that just haven’t yet come to light

 

[Newbie777]

Hello, I have been taking 80mg Atorvastatin for 5 plus years, really keen on going down to 49mg my LDL/HDL and over chloretoral is fine but my triglycerides are high, mainly du eto high fat and protein but low carb intake.

To counter measure the triglycerides I am going yo the gym and have reduced the fat rom my diet.

I tho k recent research shows that high chloretoral is not the cause of all high strokes, heart attacks or angine attacks, our bodies actually produce and need chlorestorol.

Over the coming months as I work on reducing my BG and HBa 1c, I will be doing further research and if my triglycerides go down seeing if my GP will allow me to go down to 50mg, I don't want yo go lower though.

 

[everydayupsanddowns]

I do not believe statins increase the risk of diabetes.

From the research posted above (345,417 participants, 6% with diabetes) the difference seemed to be a 0.5r mmol/L increase in Fasting Plasma Glucose, which seems fairly modest?