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    Are Statins Related to Diabetes Progression?

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    graham64
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    Are Statins Related to Diabetes Progression?

    Post by graham64 on Sun Dec 10 2017, 21:27

    Statin therapy may be elevating risk of type 2 diabetes in high-risk adults.

    Statins or HMG-CoA reductase inhibitors provide several cardiovascular benefits in addition to lowering cholesterol. This could lead individuals to believe that statins may potentially aid in reducing diabetes risk. However, in numerous cardiovascular disease (CV) prevention studies, it has been consistently found that diabetes risk is increased with statin therapy. Because diabetes is not usually a direct measure in these CV disease studies, participants are often low-risk.

    The following study aimed to evaluate the effect of statin therapy on diabetes patients who are considered high-risk. Population data was analyzed from a 3-year study called the Diabetes Prevention Program (DPP), and an extension of this study called the DPP Outcomes Study (DPPOS). The DPP is a randomized, controlled trial that studied the effect of lifestyle changes, metformin use, and placebo on high-risk patients with obesity or overweight. There were 3,234 participants randomized to receive 1 of the 3 interventions. Participants were included if they were older than 25 years of age, had obesity or were overweight, had high fasting blood sugar levels, and had impaired glucose tolerance. Following the DPP, participants were given the option to join the DPPOS extension study.

    In both the DPP and DPPOS, use of statins and other medications was obtained through patient self-report at baseline and twice yearly at follow-up visits. Statin therapy along with hypertensive therapy was determined by the participants’ primary physicians outside of the study. Lipid panels and blood pressure were recorded once yearly. Diabetes was diagnosed using a 75 g oral glucose tolerance test once yearly, or by obtaining fasting plasma glucose levels twice yearly. Cox proportional hazard models were utilized to determine the time-dependent relation between the use of statins and risk of developing diabetes on the DPP/DPPOS population.

    Results at 10 years of follow-up show that the use of statins before a diabetes diagnosis was not statistically significant among the 3 interventions. Statin use prior to diabetes diagnosis was 33% in the lifestyle intervention group, 37% in the metformin intervention group, and 35% in the placebo intervention group (P=0.36). 40% of participants were taking simvastatin, 37% were taking atorvastatin, 9% were taking lovastatin, and 8% were taking pravastatin. The use of statins increased throughout the study, becoming more prevalent after diabetes diagnosis.

    It was found that risk of developing diabetes was elevated in the participants using statins in all 3 interventions. The combined hazard ratio (HR) for the 3 interventions was 1.36 (95% Cl, 1.17 to 1.59). The study also assessed statin use duration and its association to diabetes risk. Diabetes risk was increased in participants who had been using statins for a longer period of time, with higher risk in the lifestyle intervention group. The HR per visit with statin use for the lifestyle intervention was 1.06 (1.02 to 1.11), P=0.007). In the metformin intervention, the HR was 1.01 (0.96 to 1.06). And finally, the HR for the placebo intervention was 1.02 (0.97 to 1.07). Low vs. high potency statins were also evaluated in relation to diabetes risk and no difference was found with an HR of 0.96 (0.68 to 1.35).

    Mechanisms behind how statins can potentially increase diabetes were also studied through insulin sensitivity and insulin secretion analysis. The Insulinogenic Index, a measure of insulin secretion, was statistically significant between statin users and non-statin users. Insulin secretion decreased in statin users and increased in non-statin users (P=0.013). There were no significant changes in fasting insulin values suggesting that statins have little to no effect on insulin sensitivity.

    Overall, this study showed that diabetes risk is increased in hig- risk patients who use statins. Although this study provides evidence that statins reduce insulin secretion, mechanisms behind this finding are not clear and need to be studied further. Limitations in this study include lack of randomization of participants using statins, statin use was confirmed through patient self-report, and statin dose in relation to diabetes risk was not evaluated due to limited access to this information.

    http://www.diabetesincontrol.com/are-statins-related-to-diabetes-progression/


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    Jan1
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    Re: Are Statins Related to Diabetes Progression?

    Post by Jan1 on Tue Dec 12 2017, 19:15

    Many thanks for posting this Graham ...

    The above article can also be seen here
    https://thelowcarbdiabetic.blogspot.co.uk/2017/12/are-statins-related-to-diabetes.html

    I thought readers may be interested in reading this comment by Carol, which I've copied from the low carb diabetic blog ...


    "In my opinion, statins are evil drugs. People are not told the problem of Rhabdomyolysis when they are on statins. If you have a taumatic event like a fall, or some other injury you can become quite muscularly disabled and sustain kidney damage.

    "One important cause of rhabdomyolysis is statin medications, which are cholesterol-lowering drugs that many people take. Statins include:
    atorvastatin (Lipitor)
    rosuvastatin (Crestor)
    pravastatin (Pravachol)
    Although rhabdomyolysis only occurs in a few people who take statins, so many people take these medications that it’s important to be aware of the risk.

    Other things that can cause Rhabdo include - Causes in this category include:
    a crush injury, which can occur when something heavy falls on you
    a heatstroke
    a third-degree burn
    blocked blood vessels
    a lightning strike
    intense shivering
    an ischemic limb injury, which occurs when your tissue lacks an adequate blood supply
    pathological muscle exertion
    a car accident
    intense exercise, such as marathon running.

    This is the site this information came from. Anyone on statins should be aware of these things. "

    https://www.healthline.com/health/rhabdomyolysis?utm_source=ask&utm_medium=referral&utm_campaign=asksearch#causes

    All the best Jan
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    Re: Are Statins Related to Diabetes Progression?

    Post by chris c on Tue Dec 12 2017, 22:17

    Oops! Sad
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    graham64
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    Re: Are Statins Related to Diabetes Progression?

    Post by graham64 on Tue Dec 12 2017, 22:46

    It's old news really but what stands out for is the relationship between statins and BG in diagnosed T2's something I've seen mentioned on forums too, but hey the benefits outweigh the risks so just take more anti diabetic meds to counteract the statins  Rolling Eyes


    Blood glucose should be closely monitored in diabetes high-risk patients taking statins and risks vs. benefits of statin use should be considered.


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    I'm a skinny T2 diagnosed 4/4/2008, a high calorie LCHF diet and one metformin a day A1c 6.2 and no complications.

    Proving the LowCarb sceptics wrong for over ten years

    Not all cherubs are Angels  Wink nor all diabetics Bonkers  Rolling Eyes
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    chris c
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    Re: Are Statins Related to Diabetes Progression?

    Post by chris c on Tue Dec 12 2017, 23:35

    Ah BOLLOCKS! I just lost my post with a bunch of links.

    James DiNicolantonio has been busy

    Fructose-induced Inflammation and Increased Cortisol: A New
    Mechanism for How Sugar Induces Visceral Adiposity

    http://sci-hub.hk/10.1016/j.pcad.2017.12.001

    Markedly increased intake of refined
    carbohydrates and sugar is associated
    with the rise of coronary heart disease
    and diabetes among the Alaskan Inuit

    http://openheart.bmj.com/content/openhrt/4/2/e000673.full.pdf

    Added sugars drive coronary heart
    disease via insulin resistance and
    hyperinsulinaemia: a new paradigm

    http://openheart.bmj.com/content/openhrt/4/2/e000729.full.pdf

    Postprandial insulin assay as the
    earliest biomarker for diagnosing prediabetes,
    type 2 diabetes and increased
    cardiovascular risk

    http://openheart.bmj.com/content/openhrt/4/2/e000656.full.pdf

    Meanwhile

    Prevention of complications in type 2 diabetes: is drug glucose control evidence based?

    http://bjgp.org/content/67/655/85

    Looks like ACCORD Lite

    couldn't get that one off Sci-Hub for some reason

    Comparison of low- and high-carbohydrate diets for type 2 diabetes
    management: a randomized trial

    http://ajcn.nutrition.org/content/102/4/780.full.pdf

    would no doubt have been better if they hadn't used so much Omega 6 oil IMNSHO

    You don't actually have to read this stuff, I just put it here in case one of our dietician trolls reads it by mistake and has their mind prised slightly open.


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