[ad_1]
- Doctors prescribe statins to lower the cholesterol level in a person’s blood.
- This reduces their risk of developing cardiovascular disease.
- Researchers have found associations between statins and decreased insulin sensitivity, which can lead to type 2 diabetes.
- In the current study, the team found that people with type 2 diabetes who took statins were more likely to have greater disease progression.
In a new study, researchers have found a link between the use of statins and an increased likelihood of progression of type 2 diabetes disease.
The research, published in the journal
The
If people have too much cholesterol in their blood, they are at greater risk of cardiovascular disease, heart attack, or stroke.
People can lower their cholesterol levels by staying physically active and eating foods low in saturated fat and trans fat, including fruits and vegetables. However, the FDA points out that for some people, genetic factors mean they may still have too much cholesterol, even if they follow a healthy lifestyle.
From a review of the journal clinical medicine, statins, like all medicines, can have side effects. However, the rate of side effects is so low that the benefits of taking them for someone with too high cholesterol outweigh the disadvantages.
Still, researchers want to better understand these side effects to make sure that when a doctor prescribes statins it’s the best option for the patient, and they fully understand the potential risks.
Researchers have found that a potential side effect of taking statins is a decrease in insulin sensitivity, which means a person is at higher risk for type 2 diabetes.
Type 2 diabetes is a disease in which the level of sugar, or glucose, in the blood becomes too high. This happens because an individual cannot produce enough insulin or is less sensitive to insulin. Insulin helps cells absorb glucose from a person’s blood.
By not producing enough insulin or having reduced sensitivity to it, a person’s blood sugar level increases, making them more vulnerable to cardiovascular disease.
Talk to Medical News Today, Professor Ishak Mansi, MD, Department of Medicine and Department of Population and Data Sciences, University of Texas Southwestern, Dallas, TX, and the corresponding author of this study, said understanding the clinical implications of insulin resistance due to statins was significant.
“Previous research has shown statins to be associated with increased insulin resistance. But doctors don’t routinely measure their patients’ “insulin resistance”. It’s rather done [in] research and academic circles only, but not in everyday life.
“Increased insulin resistance can lead to less controlled diabetes, [the] escalation of anti-diabetic drugs, [or both]. The global prevalence of diabetes in 2019 is estimated at 463 million people, and will increase to 578 million by 2030. ”
“With [an] increasing number of patients diagnosed with diabetes, it is important to consider whether the effect of statins on insulin resistance […] translates into any significant clinical outcome that may influence patient management, ”said Professor Mansi.
To do this, Professor Mansi and his colleagues developed a large retrospective study of the health records of patients from the Department of Veterans Affairs between 2003 and 2015.
Those selected had to have been diagnosed with type 2 diabetes during the study period, be 30 years of age or older, and regularly use the Veterans Affairs health system.
The researchers matched 83,022 people taking statins with an active comparison group of patients. The latter group was either taking a type of heartburn medication known as an H2 blocker, a proton pump inhibitor, but not taking statins.
The researchers found that 55.9% of patients taking statins had progression of diabetes during the study period, compared to 48% in the active comparison group.
Statin users were more likely to start insulin treatment, to have high blood sugar levels and complications, and to have more prescriptions for drugs that lower blood sugar levels compared to active comparator patients.
Professor Mansi told MNT that while the association between statin use and the progression of diabetes was important, it was only one of many things to consider when prescribing statins.
“[There are] three important precautions when reading our study: no patient should stop taking their statins on the basis of our study, the association does not prove causality and no study should dictate the treatment policy but [rather] all evidence gathered.
“Current guidelines from several scientific societies recommend the prescription of statins for diabetic patients between the ages of 40 and 75 with [low-density lipoprotein] cholesterol ≥70 milligrams per deciliter to prevent cardiovascular disease. Statins have been shown to reduce the risk of cardiovascular disease.
“However, our study is very important because it translated the reported results [in] academic studies on the increase in insulin resistance associated with statin use in research articles on [the] everyday language of patient care – that is, patients on statins may need to step up their diabetes treatment.
“Therefore, it may alert clinicians that they may need to be extra careful and expect to adjust diabetes medications when they initiate statins. Adjusting diabetes medications is a common practice in the management of diabetes.
Prof Mansi also pointed out that statins could still be a crucial medical intervention.
“Of course, we have to differentiate between using statins for [the] primary prevention of cardiovascular disease – that is, in patients who have never had cardiovascular disease before – and those using statins for secondary prevention – those with pre-existing cardiovascular disease. In the latter group, statins are one of the most important lines of treatment and their benefits are enormous.
Talk to MNTDr. Marina Basina, clinical professor and diabetes expert at Stanford University in California, agreed that there was a need to balance the risks and benefits of prescribing statins.
“This was a very large, albeit retrospective, study showing an association but not the causal mechanism for the progression of diabetes with statin use.”
“Information is important to help clinicians [address the] benefit-risk balance of using the drug with their patients. This risk must be carefully weighed against the significant benefits of several randomized and observational trials showing significant beneficial effects of statins in [the] reduction in cardiovascular events and mortality in people with diabetes and high risk non-diabetic patients, ”said Dr Basina.
For Dr. Basina, a healthcare professional should approach each patient differently depending on their particular situation.
“[A] a personalized approach to each patient is important. Clinicians should assess [the] cardiovascular risk factors of each patient, address [the] low risk of progression of diabetes and [the] possible need for escalating diabetes therapies.
“But at the same time, it is important to explain to the patient that the benefits of statins in [the] the reduction in cardiovascular events and mortality outweighs the risk of progression to diabetes.
” Highlighting [a] a healthy lifestyle with stopping smoking, regular exercise, and a healthy diet, is an essential part of therapy and will help to [the] reduced risk of progression of diabetes, ”added Dr Basina.
For Professor Mansi, more research is needed on the benefits and risks of statins for people with diabetes.
“We are well aware of the advantages [of statins], but the damage is much less studied – despite [the fact] that statins have been used for [more than] 30 years! Observational data and records can be an excellent method of examining this topic.
“More precisely, what is [are] characteristics of the population that might benefit less from [the] use statins for primary prevention or suffer more harm? This kind of [study] should be given priority because diabetes is very common in the [United States] and the world. Therefore, answering these questions has an impact[s] hundreds of millions of patients and cannot be postponed, ”said Professor Mansi.
Prof Mansi added that funding would also be needed to better understand some of the side effects of common drugs, such as statins.
“There should be dedicated funding for such research into the unintended side effects of commonly used drugs – not just statins. There is no dedicated funding mechanism for a study like our[s]. I can see many researchers dissuaded from doing the necessary research due to [the] difficulty in obtaining funding, ”added Professor Mansi.
High-quality studies are needed to help clinicians come up with a personalized treatment plan for people with diabetes, says Dr Basina.
“More research is needed to adapt [a] individual patient needs balancing cardiovascular benefits with diabetes risk. Large-scale randomized controlled trials are needed to answer these questions. “
“In the meantime, it is important to use [a] personalized approach to [an] risk factors for each patient, discuss [the] risk-benefit ratio of statin therapy, and [statin therapy’s] significant benefit in improving cardiovascular outcomes, especially in high risk people with diabetes, ”said Dr. Basina.
[ad_2]
Source link