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Cholesterol-Lowering Drugs May Be Linked to Diabetes

Consumer Reports Health / February 2016

You may have concerns about taking a cholesterol-lowering statin drug, such as atorvastatin (Lipitor and generic), rosuvastatin (Crestor), and simvastatin (Zocor and generic), after a recent study linked those drugs to an increased risk of type 2 diabetes. But Consumer Reports Best Buy Drugs experts say the heart-protective benefit of statins usually outweighs the risk of diabetes, so don’t skip a statin if you need one to lower your cholesterol.

Diabetes isn’t a new side effect of statins. The Food and Drug Administration added it to the label of all statins in 2012 based on a review of studies that found a slightly elevated risk. For example, one study that reviewed 13 randomized, controlled clinical trials of statins found that 4.9 percent of people who took one of the drugs for 4 years developed diabetes compared with 4.5 percent of those who didn’t take a statin.

Lower Cholesterol vs. Higher Blood Glucose

The new study, published in the Journal of General Internal Medicine, raises questions about whether the diabetes risk is higher than previously thought. Researchers looked at medical data of nearly 7,000 men and women with an average age of 53. About 31 percent of those who took a statin for an average of 5.5 years developed diabetes compared with 19 percent of those who didn’t.

But since the study was not a randomized, controlled study—the gold standard for determining whether a drug causes a particular side effect—it’s not known for sure that the increase in diabetes was entirely due to statins. The study participants might have had other factors that contributed to the development of diabetes.

"All we can say," says Ishak Mansi, M.D., an internist at the Veteran's Hospital in North Texas and co-author of the study, "[is] that in the healthy population selected ... the risk of diabetes after prolonged followup was higher than expected."

The risk of diabetes with statins is relatively low and is likely outweighed by the potential benefit of the medications to reduce LDL or “bad” cholesterol levels and prevent a heart attack or stroke, says Paul Thompson, M.D., chief of cardiology at Hartford Hospital in Connecticut. Previous research found that for every case of diabetes statins triggered, they prevented at least three heart attacks or other serious heart problems, Thompson adds.

“The bottom line is that the remote risk of developing type 2 diabetes should not deter you or influence your decision to use a statin if one is indicated,” says Marvin M. Lipman, M.D.,Consumer Reports’ chief medical adviser.

To figure out if a statin makes sense for you, our Best Buy Drug report on statins recommends using this calculator. It estimates your overall risk of a heart attack or stroke in the next 10 years based on your total cholesterol level, HDL “good” cholesterol, your age, blood pressure, and whether you smoke, or have diabetes.

Our medical advisers say that for some people with a low risk of heart attack or stroke—less than 10 percent over the next 10 years—diet and lifestyle changes should be the first step to lowering cholesterol. That includes adopting a healthy diet that is low in saturated fats, trans fats, and cholesterol, and making lifestyle changes such as exercising and losing weight if you need to or quitting smoking if you are a smoker.

Those changes could reduce your LDL and your heart attack and stroke risk low enough that you won’t need to take a statin. Or, if you already take a statin, these changes might allow you to discontinue your medication or lower your dose, which can in turn reduce your risk of side effects.

Our medical advisers also recommend that you use the calculator to look at how much taking a statin would reduce your risk. And talk with your doctor. You might find that reducing your cholesterol levels with a statin will not make much difference in your 10-year risk of heart attack or stroke. If that's the case, then skip it.

Consumer Reports has no relationship with any advertisers on this website. Copyright © 2006-2016 Consumers Union of U.S.

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Zika: The Dangerous Mosquito Virus You Must Know About

Insect repellents aren't enough to stay safe from this disease

Consumer Reports / Sue Byrne / January 28, 2015 / aired on GMA February 9, 2015

A mosquito-borne illness called the Zika virus is now spreading rapidly in South and Central America and the Caribbean, and it could arrive in the U.S. soon. It can make anyone sick for up to a week with symptoms like fever, rash, joint pain, and red eyes. But it's especially dangerous for women of childbearing age who are pregnant or considering pregnancy because it has been linked to microcephaly, a serious birth defect that causes an abnormally small head and incomplete brain development.

The outbreak has prompted the Centers for Disease Control and Prevention to issue a warning to take precautions for anyone traveling to 24 destinations in the Americas, but, most important, the CDC is recommending that all pregnant women should consider postponing their trip altogether. Here's what you should know to protect yourself and your family.

Why Zika Is So Concerning

The Zika virus normally does not cause illness that requires hospitalization or leads to death. Roughly one in five people infected with the virus develop symptoms, which are usually mild. The time from getting bitten to getting sick is likely to be a few days.

The Pan American Health Organization (PAHO) reports more than 16,000 Zika illnesses since the first cases were confirmed in Brazil in October 2015. Local transmission of the virus has been confirmed through lab testing in several countries in the Americas.

"The number of cases being reported is significantly lower than the actual number of cases." says Candice Burns Hoffmann, a CDC spokeswoman. "Many countries do not regularly test for Zika virus. Also, once the outbreak becomes common in an area, most people will not go to the doctor or get tested for the virus."  

Brazil has reported 4,180 cases of microcephaly, according to The New York Times, and Colombia has reported Zika infections in 1,090 pregnant women, a spokeswoman for PAHO told Consumer Reports. In addition, Guillain-Barré syndrome, which causes muscle weakness and sometimes paralysis, has been reported in patients with a probable Zika infection in French Polynesia and Brazil. The CDC says it is examining the link between Zika and the disorder.

Because there is neither a vaccine nor medication available to prevent a Zika virus infection, the American College of Obstetricians and Gynecologists recommends that women who are pregnant or considering pregnancy follow CDC guidelines and delay travel to those regions where Zika outbreaks are occurring.

"There is much that we do not yet know about the Zika virus," Mark S. DeFrancesco, M.D., president of the ACOG, said in a statement. "However, because of the associated risk of microcephaly, avoiding exposure to the virus is best." Women who have traveled to South and Central America and the Caribbean should be evaluated for Zika virus infection.  

How to Prevent Bites

For those who are planning to travel in spite of the warnings, the CDC asks that pregnant women, women who are trying to become pregnant, and everyone else should strictly follow steps to protect themselves. Because the mosquitoes that spread Zika are aggressive daytime biters and live indoors and outdoors, it's especially important to follow the CDC's precautions during daylight hours.

That includes using insect repellent containing deet, picaridin, lemon eucalyptus, or IR3535. All have been approved by the Environmental Protection Agency for use during pregnancy. Also wear long-sleeved shirts and pants, the CDC says. At night, CDC recommends sleeping in a screened-in or air conditioned room or under a mosquito bed net.

Consumer Reports' recent tests of insect repellents found that the most effective product, Sawyer Fishermen's Formula with 20 percent picaridin, was also one of the safest, helping to keep away Aedes mosquitoes—the same type that transmit Zika—for at least 8 hours. Off Deepwoods VIII with 25 percent deet also kept Aedes mosquitoes at bay for 8 hours. Our tests showed that repellents containing natural plant oils, such as citronella and lemongrass, did not work against mosquitoes.

Two types of mosquitoes that are capable of transmitting the Zika virus live primarily 

in the southeastern U.S. Photo: Courtesy of the Centers for Disease Control and Prevention

More Actions to Take

All cases of Zika virus in the U.S. so far have been found in returning travelers to the regions mentioned above. No one has gotten sick from being bitten in the U.S. But that may be changing as the two mosquito types known to carry the disease, Aedes aegypti and Aedes albopictus, can be found here (see maps above). If a homegrown mosquito bites an infected returning traveler it could pick up the virus and then pass it along to other people in the U.S.  

For this reason, it’s wise to use insect repellent, as noted above. You can also make it harder for mosquitoes to set up shop in your backyard. Female mosquitoes lay several hundred eggs on the walls of water-filled containers. The eggs stick like glue and remain attached until they are scrubbed off. If water covers the eggs, they hatch and become adults in about a week. To prevent them from hatching:
• Empty and scrub, turn over, cover, or throw out items that hold water, such as tires, buckets, planters, toys, pools, birdbaths, flowerpots, or trash containers. Do this once a week.
• Tightly cover water storage containers (buckets, cisterns, rain barrels) so that mosquitoes cannot get inside to lay eggs.
• Use wire mesh with holes smaller than an adult mosquito if you don't have lids.

If you have a septic tank, repair cracks or gaps, and cover open vents or plumbing pipes.

For more info go to ConsumerReports.org:

http://www.consumerreports.org/insect-repellent/zika-the-dangerous-mosquito-virus-you-must-know-about?loginMethod=auto

almost crawling

Looks like Dexter will be sharing the floors in the house 
with this cute little one!

Watch out Dex ... trouble will be coming your way soon!