Statins dilemma: heart & cancer benefits, but diabetes risk

There are many statins available now.

Statins have been hailed as some of the best drugs ever.

Given the massive, deadly prevalence of cardiovascular disease, some have even semi-jokingly talked about putting these drugs in the water supply for public health.

The growing evidence (e.g. this story) that statins might significantly aid in prevention, delayed progression, or even post-treatment delay of recurrence o cancer seemed to add to the glowing rep of these drugs. As a prostate cancer survivor, the news on statins and prostate cancer seemed particularly notable.

But then another narrative has been developing that is not all statin peaches and cream. Statins impair glucose metabolism and very strongly increase the risk of developing diabetes. This connection seems like the real deal. The higher the dose of statins taken, the greater the risk.

The link between statins and Diabetes is not some small increased risk either, but a rather huge effect.

Dang, I knew the story was too good to be true.

It’s not clear how a statin throws a monkey wrench into some patients’ systems to trigger Diabetes either so that may make it harder to say engineer a new statin that doesn’t pose the Diabetes risk any time soon.

I guess we’ll all have to stay tuned on this one and this dualism reinforces the idea that there is no “free lunch” when it comes to medication. There will always be potential for side effects. Always. Whether we are talking about chemical drugs or biological drugs like stem cells. Frustrating, but true.

7 thoughts on “Statins dilemma: heart & cancer benefits, but diabetes risk”

  1. I just want to make sure that you noticed my message.

    To 10% of us, statins are poison. Please, please, get genotyped. If you can’t do that, at least pay attention to the symptoms. If you start feeling muscle pain or weakness while taking statins, it could well be your genome talking.


  2. To simplify what I said earlier: it’s still possible that the same variable(s) that causes increased cholesterol also caused increased incidence of diabetes and the statins act down stream of the common pathway and only (mainly) affects the cholesterol side. This is not incompatible with the dose response observation.

  3. This study didn’t isolate the possibility that there is a confounding variable that causes the increase in diabetes. What comes to mind for me is that the people who required higher statin levels to control cholesterol have some other variable which both causes the increase in cholesterol and the increased propensity for diabetes (eg a cohort of genetic variables). This same variable which requires higher levels of statins to control cholesterol also leads to greater susceptibility to diabetes. People would have to be randomly assigned varying levels of statins (regardless of cholesterol level) and studied over a similarly long period to suss this out… or it could be the statins leading to diabetes.

  4. I am not antimedication in general at all. There are great meds out there for many applications and they do a lot of good. But there are too many high quality studies performed over long time lines for too many decades that show problems with statins. These drugs do not decrease overall mortality in a population at all. I really cannot get past that. They may be valuable for people with very specific conditions… but the evidence just not add up that they should be given on principle to everyone. They also have MANY food and drug interactions.

  5. I think a key thing you mentioned is dose. We published a study when I was at Stanford looking at the effects of statins on iPS derived endothelial cells from diabetic/obese mice, and the interesting part was that low dose pravastatin seemed to reverse some of the negative effects of obesity and diabetes on the vasculature, but higher doses did not (in some cases higher doses actually induced cell death).

  6. Yikes! A fair number of people of European descent have gene variants (detected by SNPs- single nucleotide polymorphisms) that make them susceptible to a debilitating side effect. People get muscle aches, which they attribute to other causes, and many will get muscle atrophy.

    I know this because I have both of the SNPs associated with this effect. So, when my physician wanted me to try a statin, I agreed to do an experiment. After 3 weeks on the lowest dose of Crestor, taken just 3 times a week, all of my muscles hurt. It took 2 weeks to recover after I stopped taking it.

    Statins are poison for me and others with similar genetics. Please don’t put it in the water!

  7. Statin drugs have many adverse effects — perhaps because they do a number on mitochondria

    But wait, it gets worse. The statistics quoted in drug advertisements are misleading

    I’d sum it up this way. You have to administer statin drugs to a lot of people for a long time in order to “theoretically” save one person from getting a heart attack. In the meantime, a great many people are going to suffer adverse effects.

    Bad for nerves
    Bad for arthritis

    Statin drugs are VERY good for drug companies.

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