Getting A Second Option On Strategies To Reduce Risks Of Diabetes
Whenever we prescribe any medication, we run a risk/benefit analysis, says Seth J. Baum, MD, immediate past president of the American Society for Preventive Cardiology, and medical director of womens preventive cardiology at the Boca Raton Regional Medical Center in Florida who reviewed the study findings for EndocrineWeb.
We look at the particular patient and consider any risks for cardiovascular disease including events like stroke. If you have a high risk of a cardiac event, its a no braineryou should take a statin. Its when there is a more modest risk that a more in-depth discussion should take place regarding whether potential risks outweigh the known benefits of taking a statin.
In effect, it comes down to the fact that having cardiovascular disease poses a more imminent risk than developing type 2 diabetes, says Dr. Baum. Diabetes is a continuum based on blood glucose and A1c levels, he says. You cant say that someone with a blood sugar level of 6.5% is much sicker than someone with an A1c of 6.3%. Maybe youve crossed a numeric threshold, but what has really changed? Whereas with heart disease, its binary. You have a stroke, or you dont. You die or you dont.
Once you start taking a statin, you should see your doctor regularly to have your blood sugar checked,6 according to the Food and Drug Administration.
Foods And Drinks That Can Cause Blood Sugar Swings
Is your blood sugar up and down? Certain foods and drinks could be to blame.
Just when you think youre making all the right food choices, your blood sugar takes a leap or dive. Foods and drinks can have an impact you might not expect, and these surprise blood-sugar changes can be harmful . Here are some things you should consider:
Dont let bagels betray you. Counting carbs is a way of life when you have diabetes. Bread can really rack up those carbs, but not all bread is created equal.
Think theres no difference between a bagel and an English muffin? One plain English muffin has 140 calories and 27 grams of carbohydrates. A bagel thats 4½ inches in diameter serves up 294 calories and 58 grams of carbs. Thats about as many calories and even more carbs than a glazed donut.
Its about portion size. Some bagels are the size of a plate, says Pamela Allweiss, MD, MPH. Shes a medical officer in the division of diabetes translation at the CDC.
A fruit in any other form may be twice as sweet. All fruits have sugar, but did you know that different forms of the same fruit have vastly different amounts?
Dried fruit packs a sugary punch compared with its fresh counterpart. Ten grapes, which weigh about 1.75 ounces, have 34 calories and 8 grams of sugar. Theyre also full of water, which helps fill you up. A 1.5-ounce, single-serving box of raisins packs 129 calories and 15 grams of sugar, but none of the water.
What Are The Side Effects Of Statins
Statins side effects may include the following:
- Some studies have shown statins increase risk of depression and impair cognitive ability
- One stati, simvastati, could lead to a rare kidney problem
- The FDA has warned that patients on statins are more likely to develop myopathy, including rhabdomyolysis in rare and serious cases
- Liver function can sometimes be affected
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Readers Share Stories About Statins And Diabetes:
Berry in Surprise, Arizona, had a similar experience:
I had my A1c go to 6.5, I was taken off of statins and it went to 5.4. Why arent people told the cause of diabetes is the statins?
Geetha in India developed diabetes after taking rosuvastatin :
I had no problems with my sugar until I started taking rosuvastatin. At first, the statin caused body aches and pains and unexplained abdominal discomfort. I stopped taking it and felt much better. But my doctor said because of my borderline cholesterol and high trigs including LDL and VLDL, I had to take statins.
Now, after a year of taking statins my cholesterol levels are completely normal but I have diabetes. My glucose is 216. I have body aches and extreme fatigue along with leg cramps, thirst and frequent trips to the bathroom at night. This makes it hard for me to sleep well at night.
During the day I tire easily and suffer from extreme fatigue after the mildest of activities. I am 62 and female.
T.S. shared this story of statins and diabetes:
Statins For Primary Vs Secondary Prevention
But these risks do suggest that people prescribed statins would benefit from having a frank discussion about the risks and benefits of these medications, Dr. Mansi says. Thats particularly true for people with type 2 diabetes who dont have a history of cardiovascular disease, he adds. Roughly three in four patients on statins in the study didnt have a previous heart problem.
We have to differentiate between using statins for primary prevention of cardiovascular diseases that is, in patients who never had any cardiovascular disease previously and those using statins for secondary prevention: those who have preexisting cardiovascular disease, Mansi says.
In the latter group, statins are one of the most important lines of treatment, and their benefits are great, he says. More research is needed to determine if statin therapy is best reserved only for people with type 2 diabetes who already have cardiovascular disease or a history of heart attack or stroke, Mansi adds.
The study wasnt a controlled experiment designed to prove whether or how statins might directly cause diabetes progression. Its possible that statins interfere with processes that control how well the body produces and uses insulin, a hormone critical for maintaining healthy blood sugar levels, the study team notes in the paper.
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Focus On Healthier Strategies To Ward Off Diabetes & Heart Disease
Patients should think more about preventing diabetes and cardiovascular disease, says Dr. Zigmont, as obesity is a risk factor for both conditions.
Reinforcing the points made by Dr. Baum, she urges individuals who are concerned about diabetes to put aside any worry about statins, and instead to double down on making lifestyle changes that can go a long way in reducing your risk of developing diabetes. After all, we know that individuals who avoid weight gain, and those who manage to lose weight have the best chance of reversing the fallout of diabetes and can avoid the complications that come with this otherwise chronic, lifelong disease.
Conversely, statins are needed specifically to reduce the risk of heart attack and stroke, and they are incredibly effective at doing so, she says. It is important to take cholesterol-lowering mediation when you have a higher risk of cardiovascular disease, especially if you are a woman in post-menopause.
For those of you who are concerned about side effects, there is anecdotal evidence that changing the brand of statin may relieve some adverse symptoms rather than stopping statin therapy. Also, dose changes can help to manage any negative reactions such as the rare occurance of muscle pain, while still allowing for the huge benefits, lessening the chance that youll have a cardiac event.
What Statin Should You Take
Your healthcare professional will take into account several factors when prescribing a statin. These include your cholesterol levels, risk factors you might have for heart disease, and your individual tolerance of the specific medication.
There are several statin medications, each with differing potency and dosage levels. As mentioned previously, the ADA recommends different intensity levels of statin therapy for people with diabetes, usually a moderate- or high-intensity statin.
Low-intensity statin therapy in people with diabetes is usually only recommended by the ADA when higher intensity therapy is not well tolerated.
Statin medications with a lower potency include Pravachol and Altoprev . Moderate-potency statins include Zocor and Lipitor at lower to moderate doses.
If your cholesterol is especially high, or you have several cardiovascular risk factors, your healthcare provider may prescribe a stronger high-potency statin, such as Crestor or atorvastatin at a higher dose.
How well you tolerate a statin is an essential factor when choosing which statin to prescribe. Depending on your healthcare provider, they might start with a lower potency statin and increase intensity later if your cholesterol levels do not improve enough.
Alternatively, they may opt to start with a higher potency statin, then adjust the type of statin or lower your dosage if it is not well tolerated.
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Patient Stories Re: Statins And Blood Sugar
Russell in Hawaii shares his experience:
I have Type 2 diabetes and was prescribed Lipitor about six months ago. My morning sugar has been moderately elevated but under control with metformin.
After reading all the potentially bad things about Lipitor and paying for tests which determined I have no heart disease, I quit using Lipitor two weeks ago. Immediately the next day, my morning sugar went to normal and is no longer moderately elevated.
Cindy in PA states:
I am a 58-yr-old female with no history of diabetes in my family. I have been taking 80 mg of pravastatin for about 3 years and now I am pre-diabetic.
There is no history of heart disease or stroke in my family. Now that I am reading about this risk I am very angry with the medical community. My doctor insists I stay on cholesterol meds regardless of the pre-diabetes.
I am not overweight nor is my diet bad. I never consume sugar and constantly watch my carbs & have done this for years. It is definitely the statins causing this.
Lucy shares her family history:
I am 50 and I never had high blood sugar, but I do have high cholesterol and have had for over 30 years. I was put on simvastatin and my normal blood sugars went from 85 to over 100.
The doctor says type 2 diabetes is hereditary. My mom is 89 and has normal blood sugar levels, and my dad died in his late 80s and had normal blood sugar levels. In fact, nobody in my family has had diabetes. I am normal weight.
Rich in Florida:
Statins Help Reduce Heart Risks In People Diagnosed With Diabetes
According to Johns Hopkins Medicine, people with diabetes are two to four times more likely to develop cardiovascular disease than people without diabetes, and cardiovascular disease is the most common cause of death in people with diabetes.
Research has long shown that statins reduce heart risks among people with type 2 diabetes. For example, one study published more than a decade ago in Diabetologia examined the effect of statins on 589,091 people with type 2 diabetes. Before statin therapy, 94 percent of them had at least a 10 percent chance of experiencing an event like a heart attack or stroke in the next decade. After four months on statins, the proportion with this level of cardiovascular risk dropped by 7 percent.
People with diabetes should definitely take statins, because the benefits of statins in terms of reducing cardiovascular events far exceeds any potential risk of the statin, Dr. Newman says.
As for people without type 2 diabetes, concern about developing this condition shouldnt stop them from taking statins, either, Newman adds.
Statins increase the risk of newly diagnosed diabetes in a small percentage of patients, Newman notes. However, studies show that those patients who develop diabetes have multiple preexisting risk factors for diabetes, such as prediabetes and metabolic syndrome, and would generally develop diabetes in the long term even if they didnt take statins.
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Glyburide Taken With Statins Suppressed Immune Response
After investigating further, the research team found that statins activated a very specific immune response, which stopped insulin from doing its job properly, says Prof. Schertzer.
After connecting the dots, he and his team discovered that taking another drug called glyburide alongside statins suppressed this immune response.
This finding could yield the development of new targets for this immune pathway that do not interfere with the positive effects of statins, they say.
For future research, Prof. Schertzer and colleagues want to understand how statins advance diabetes by understanding how the drugs work in the pancreas, an organ that secretes insulin. Other side effects include muscle pain and muscle breakdown, and the team hopes to understand whether the immune pathway is involved in such side effects.
Its premature to say we are going to change this drug, says Prof. Schertzer, but now that we understand one way it can cause this side effect, we can develop new strategies to minimize side effects.
He adds that they could even possibly use natural products or strategies involving nutrition to counter these side effects.
Because statins are so widely prescribed, the researchers say understanding how they prompt adverse effects could lead to vital improvements in the drug, which could ultimately affect a large portion of the population.
Prof. Schertzer concludes by noting:
Dangers Of Statin Drugs: What You Havent Been Told About Popular Cholesterol
Hypercholesterolemia is the health issue of the 21st century. It is actually an invented disease, a problem that emerged when health professionals learned how to measure cholesterol levels in the blood. High cholesterol exhibits no outward signsunlike other conditions of the blood, such as diabetes or anemia, diseases that manifest telltale symptoms like thirst or weaknesshypercholesterolemia requires the services of a physician to detect its presence. Many people who feel perfectly healthy suffer from high cholesterolin fact, feeling good is actually a symptom of high cholesterol!
Doctors who treat this new disease must first convince their patients that they are sick and need to take one or more expensive drugs for the rest of their lives, drugs that require regular checkups and blood tests. But such doctors do not work in a vacuumtheir efforts to convert healthy people into patients are bolstered by the full weight of the US government, the media and the medical establishment, agencies that have worked in concert to disseminate the cholesterol dogma and convince the population that high cholesterol is the forerunner of heart disease and possibly other diseases as well.
The drugs that doctors use to treat the new disease are called statinssold under a variety of names including Lipitor , Zocor , Mevacor and Pravachol .
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What Happens To Your Body When You Drink Soda Sugar Affects Brain Heart Lungs And Teeth
The immediate effects of soda are well-documented. About 20 minutes after you finish the can, it hits you 100 percent of your recommended daily intake of sugar, or 10 teaspoons.
Your blood sugar spikes, causing an insulin burst that tricks the liver into converting all sugars into fat. Within 40 minutes, caffeine absorption is complete, and the rest of your body responds accordingly: Your pupils become dilated, your blood pressure rises, and the liver begins to dump even more sugar into your bloodstream.
Thats only the first hour. Over time, a couple of sodas a day will start to affect nearly all parts of your body. For example:
A daily can of soda has a negative effect on virtually every part of the body, including the heart, lungs, and brain. Photo Courtesy of Shutterstock
Diet Soda Diabetes And Eye Disease
Unfortunately, increased mortality rates arent the only bad news surfacing from diet soda studies.
A 2018 study found that people with diabetes who consumed more than 4 cans of diet soda per week were two times more likely to develop a diabetes complication called proliferative diabetic retinopathy .
But if you read the entire study, the authors reported that those with increased risk of retinopathy were those with type 1 diabetes, had a greater BMI, 55 percent were current smokers, had elevated blood fat levels, and high blood pressure which can all contribute to the development of eye disease.
When authors adjusted the results for variables such as A1c levels , age, gender, smoking, etc., there was no difference in eye disease between the diet soda drinkers and the non-consumers except those with the highest consumption.
So, everything in moderation even no calorie soda is still a good motto to live by.
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Raising Blood Sugar And Insulin Levels
Consuming excess sugar has been shown to increase blood sugar and insulin levels. When your insulin levels increase, your sympathetic nervous system is activated . When this happens, your heart rate increases and your blood vessels constrict. This raises your blood pressure .
Increased blood sugar levels can make your body more insulin resistant. In addition to diabetes, insulin resistance is linked to high blood pressure .
How Does Diabetes Affect Cholesterol
Not only does diabetes affect your blood glucose levels, but it can also affect your cholesterol levels. Diabetes can lower HDL good cholesterol levels while increasing LDL bad cholesterol and triglyceride levels. This is called diabetic dyslipidemia, meaning your blood cholesterol results are going in the wrong direction.
Diabetic dyslipidemia can raise your risk for atherosclerosis, heart disease, and stroke. Research suggests an association between insulin resistance and diabetic dyslipidemia. Associations are also seen for atherosclerosis and blood vessel disease.
Insulin resistance occurs when your muscle, fat, and liver cells dont respond well to insulin and cant easily remove glucose from your blood. Insulin resistance often begins well before type 2 diabetes is diagnosed. Thus, associated cardiovascular conditions can develop even before you have diabetes.
The American Diabetes Association recommends routine screenings for type 2 diabetes for everyone every three years after age 35, and more frequently if symptoms develop or risks change . Routine screenings may be recommended by your healthcare provider if you’re under 35 but have certain high-risk factors, like being overweight or obese, a family history of the disease, heart disease, high blood pressure, a history of gestational diabetes, and/or a sedentary lifestyle.
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