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.
