Raise caution that the use of statin medication to improve lipid levels may, as a side effect, increase the risk for type 2 diabetes. Providers are encouraged to regularly monitor glucose levels in those without diabetes but not discontinue the use of statin medication because of its cardiovascular benefits.
Even though statins may increase the risk of diabetes or have a minor effect of interfering with blood sugar control, statin therapy is recommended for all diabetic patients. Patients with diabetes do not die of high blood sugar. They die of heart attacks and strokes. The longer they have diabetes, the greater the risk. In diabetic patients with heart artery disease, statin treatment for five years reduced the risk of heart attack, stroke, and death by about half. Below are quotes from the latest American Diabetes Association Guidelines.
For patients without vascular disease or chronic kidney disease:
For people with diabetes aged 40–75 years without ASCVD, use moderate-intensity statin therapy in addition to lifestyle therapy.
For patients with artery disease or chronic kidney disease:
For people of all ages with diabetes and ASCVD, high-intensity statin therapy should be added to lifestyle therapy.
High Intensity Statin Therapy
Atorvastatin (Lipitor) 40 mg.
Atorvastatin (Lipitor) 80 mg.
Rosuvastatin (Crestor) 20 mg.
Rosuvastatin (Crestor) 40 mg.
While statins may modestly increase the risk of diabetes, or make the glucose a little harder to control, their benefits dramatically outweigh that risk. Statins don’t just lower the cholesterol. They increase nitric oxide production, the active ingredient in nitroglycerine tablets that relieves chest pain. They stabilize cholesterol deposits so that they do not rupture and cause a clot that blocks the artery. They prevent clot formation and they are anti-inflammatory and antioxidant. Beyond their cholesterol lowering effects, they interfere with the factors that cause arterial disease, heart attack, and stroke.
Despite these massive benefits, only 31% of patients with diabetes without artery disease take a statin. Only 66% of those with arterial disease are on a statin. It is possible to achieve 91% statin treatment in a high-risk population. Patients are dying every day because we are not following the evidence to assure that patients receive the best treatments. When patients with diabetes are on optimal medical therapy, including a statin, they have one fourth as many heart attacks and one fifth as many strokes.
Without a fundamental lifestyle optimization as the primary focus, all medical therapies fail ultimately.