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Mark Hyman, MD

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Statins May Cause Diabetes, New Study Says

Posted: 06/21/11 04:21 PM ET

If all doctors followed the latest cholesterol treatment guidelines and all their patients took their prescribed statin medication, there would be 3.5 million more diabetics in America. But wait! There is another pill (or injection, actually) that has been shown to reduce the risk of diabetes. And it's only about $50,000 per year per patient. Let's see: 3.5 million, times $50,000. What does that bring us to?

Pharmageddon!

We are stuck in an absurd cultural habit of thinking that medication will save us from lifestyle and social diseases.


Two separate studies in today's issue of the Journal of the American Medical Association (JAMA) underscore that we have come to the end of an era of being saved by medication. Antibiotics and vaccines were a huge advance in medicine in the 20th century. But the single pill for the single ill just doesn't work for 21st century chronic diseases like heart disease and diabetes.


Statins cause diabetes

The latest cholesterol guidelines (ATP III) increased the number of Americans who should take statin therapy from 13 to 40 million. Those additional 27 million are ones without heart disease, but who have high cholesterol. This type of treatment is called primary prevention. I have extensively reviewed the research on using statins to prevent heart attacks in people who never had them. The data is weak and shows no benefit, except the Jupiter trial, which ONLY showed benefit if patients also had inflammation (high C-reactive protein), not just high cholesterol or LDL. If you just had an elevated cholesterol, statins didn't help.

I have previously written about research that showed that statins increase the risk of diabetes. This latest study examined five major clinical trials on statins that included 32,752 non-diabetics over 4.9 years. During the study period, 2,749 patients (or 8.4 percent) developed diabetes. Those on the highest doses of statins (which are increasingly prescribed by physicians) were at the highest risk of developing diabetes.

While there was a slight overall reduction in risk of heart attacks in the patients treated with statins, the authors found that you have to treat 155 people for one year to prevent just one heart attack or death. If a doctor had to prescribe antibiotics to 155 people to cure just one patient of pneumonia, we would think that antibiotics weren't very good medication. But that is exactly the "number needed to treat" to prevent just one cardiac event. On top of that, for every 498 people treated, one more person would become diabetic. If these drugs were not the top-selling drugs in history, we might accept a small risk, but if we treated everyone who "needed" them, we would have more than 3.5 million more diabetics in America.

Using statins may be an acceptable risk if there was no other treatment for heart disease. And we spend more than $100 billon a year on angioplasties (which don't benefit 95 percent of people receiving them), and cardiac bypasses (which reduce the risk of death in only 3 percent of people who receive them), while ignoring that heart disease is a lifestyle and social disease that requires lifestyle medicine and a social cure that would prevent more than 90 percent of all heart disease.

Immune-suppressing medication prevents diabetes

In another study of nearly 14,000 patients, published in today's issue of JAMA, researchers from Harvard found that those treated with powerful immune-suppressing medications (TNF alpha blockers like Remicade or Enbrel), reduced their risk of getting diabetes.

Sounds great. We have an explosion of diabetes. By 2020, one in two Americans could either have pre-diabetes or diabetes. The authors said "there is evidence suggesting a possible role for ... immunosuppression in diabetes prevention." But the side effects of these drugs are overwhelming infection, increased cancer risk and death. And they cost about $50,000 per year, per patient. Were the authors serious about using these drugs for diabetes, another lifestyle and social disease?

Yes, diabetes is an inflammatory disease. And yes, reducing inflammation can prevent and even reverse diabetes. But it won't be by taking aspirin, Advil, or some high-powered immune suppressing, toxic, expensive medication. The major cause of inflammation is our processed, high-sugar, low-fiber, fast food, junk food, calorie-dense, nutrient-poor industrial diet and our couch-potato lifestyle. A plant-based, whole foods, real-food diet without sugar and flour in pharmacologic doses along with anti-inflammatory omega-3 fats and a good dose of exercise can dramatically reduce the risk of and even reverse heart disease and diabetes. And they cost a lot less.

Last week, a study in JAMA found that the risk of diabetes, heart attacks and death increased significantly with more than two hours of television watching per day. The average American spends seven to nine hours in front of a screen every day. We have a social problem, a host of chronic diseases driven by a food industry and screen-dominated culture and the breakdown of communities. Cooking real food takes a bit more time, but people spend more time watching cooking shows on television than actually cooking.

The answer to our exploding health care costs and burgeoning chronic disease is not going to be found at the bottom of a pill bottle, but at the end of our forks and the soles of our shoes. Please save us from Pharmageddon.


Mark Hyman, M.D. is a practicing physician, founder of The UltraWellness Center, a four-time New York Times bestselling author, and an international leader in the field of Functional Medicine. You can follow him on Twitter, connect with him on LinkedIn, watch his videos on YouTube, become a fan on Facebook, and subscribe to his newsletter.

 
 
 

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If all doctors followed the latest cholesterol treatment guidelines and all their patients took their prescribed statin medication, there would be 3.5 million more diabetics in America. But wait! Ther...
If all doctors followed the latest cholesterol treatment guidelines and all their patients took their prescribed statin medication, there would be 3.5 million more diabetics in America. But wait! Ther...
 
 
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Maggie Keavey Kozel
09:46 AM on 07/27/2011
I don't understand your cause and effect conclusions, Dr. Hyman. Patients on higher doses of statins are more likely to develop diabetes? Might that not suggest that this group had more challenging lipid profiles (hence the higher doses they were on) and therefore were more likely to be obese and develop diabetes, as part of a more severe pattern of metabolic syndrome? I agree with so much of what you propose in terms of nonpharmacological strategies, but we have to be responsible about the way we present the data if we are to remain credible.
01:41 PM on 08/03/2011
And I agree with that. As soon as I read it I asked, well, how did the study control for compounding factors such as, obviously, obesity. I'd like to read the JAMA study he refers to so I can understand that, but I'm left to search the JAMA table of contents and figure out which it is based on the date since he decided it was not important enough to include a citation.
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James Swick
Enjoying the spectacle
09:12 AM on 07/16/2011
I stopped taking statins 6 years ago because of muscle weakness. I searched for alternatives for lower cholesterol. I found that Grape Seed/Skin Extract & red wine (Pinot Noir has the highest content polyphenols) do the job. My last cholesterol reading was 175 and probably too low.
12:32 PM on 07/10/2011
True, true and unrelated........the dangers of taking a non randomized, non controlled, non blinded study and attempting to draw cause and effect relationships is never more apparent than in this article. This is an epidemiologic study which can at best SUGGEST that there might be an association with statins and diabetes. Alternatively, due to a lack of control population (same age, same weight, same potential for diabetes over time), the apparent relationship suggested in this report may be just plain WRONG. Only a randomized controlled trial can make a cause and effect statement. Until such a study is done, this article is one man's opinion as opposed to scientific evidence.

I have no issue with those who "quote the literature", I do have an issue when they do not understand the underlying limitations of the study and misinform those who need the information most.
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11:46 AM on 07/14/2011
I would risk the 1 in 500 chance of developing diabetes in order to gain the 1 in 150 chance of avoiding a major cardiac event if I had coronary artery disease. Diabetes is a treatable condition and
most diabetics live a fairly normal life, but a cardiac event could be fatal immediately.
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alykatma
04:11 PM on 07/16/2011
The article doesn't mention other side effects of cholesterol lowering drugs: congestive heart failure, rhabdommyolysis(muscle pain and deterioration) kidney failure, erectile dysfunction, loss of memory and loss of mental focus. I had the muscle symptoms after taking Zocor and Zetia for 2 years. Since those were the only 2 meds I was taking I knew they were the culprits. I bet my doctor did not even report that I had reaction. I researched and decided I was going to take em anymore. I have never felt better. My sisters are both diabetic and I asked them, what came first? The Statins or the diabetes? The statins came first. They are both on several medications. Mom was on Lipitor and died of congestive heart failure/altzheimers. Dad died of complications of diabetes and also took Lipitor for many years. Mother-in-law took Lipitor then Baycol(which was recalled BTW) and spent the last several years of her life in a wheelchair before she also died from gut attack(blood flow to gut stopped and she died of septic shock.) I take nothing, and will take nothing unless I am ill.
06:48 PM on 07/08/2011
We should be looking at the chances of being dead in say five years from any cause in people who take statins versus people who don't . If statins reduce the risk of heart attack a tiny bit , what is the difference if one's overall risk of death is a given period goes up from diabetes , Parkinson's or any other cause due to a statin adverse reaction ?
09:48 PM on 07/04/2011
That is interesting, and it seems that our health life is beginning to mimic our global connectedness; one small change here can have a big effect there. I was particularly startled by the claim that "By 2020, one in two Americans could either have pre-diabetes or diabetes." That is amazing and unsettling.

What is also unsettling is the high rate of diabetes in impoverished communities, like the one that I live in and the rate amongst African-Americans: http://michaelmaczesty.blogspot.com/2011/06/unzipping-obesity-by-zip-code-and-race.html
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Parkite
Still haven't found what I'm looking for
07:15 PM on 07/04/2011
One of the major adverse effects of statins is that they weaken heart function. Statins inhibit the body's production of Coenzyme Q 10, which is essential for heart function. So while some statins do have some beneficial effects, the weakening of heart function outweighs them when there are other treatments for those side benefits.
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capitaldysfunction
White male never voted Republican
03:41 AM on 07/03/2011
Everything Dr.Hymen says in this piece strikes me as smart medicine. Nonetheless, we all know medical studies fly in all directions. The May, 2011 "Harvard Men's Health Watch", a publication of Harvard Medical School (www.health.harvard.edu) doesn't contradict Dr. Hymen's report but it specifies a significant number of conditions other than diabetes-- almost too numerous to cover here-- that statin drugs generally render better. Therein lies the quandary, doctor. I'm 64. I don't have diabetus, heart disease, or high cholesterol. I have not been taking statins but my medical plan provides them without charge. Please don't say just die and save us all the painful details, doc:)
06:50 PM on 07/08/2011
Where is your proof that if you divide a group in two and give half statins and give the other half a placebo, the statin group will be more likely to be alive in ten years ?
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capitaldysfunction
White male never voted Republican
09:39 PM on 07/08/2011
I don't have any. I don't take statins and I probably will not take them without further evidence. The diabetic study is quite worrisome.
TryToBeFlexible
MENSA, Gay, Atheist, Believer in justice, age 57
02:49 PM on 07/01/2011
Huge percentages of people refuse to keep taking statins once they have tried them for awhile. I have tried several times, but the pain, muscle, and nerve issues make me wish I were dead, so I stop taking it. Even though the liver tests shows no liver damage. Beside diabetes, you can end up with all kinds of devastating side effects from statins. All for the vague, tiny, chance of a benefit, as based on drug studies done by the very corporations most to gain from you using this drug.
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Parkite
Still haven't found what I'm looking for
07:22 PM on 07/04/2011
Statins are not the panacea that they were once believed to be. But many doctors and patients have been hoodwinked by all the advertising and other promotion to both doctors and the public.
04:18 AM on 06/30/2011
Vitamin D is MUCH more effective, and safe, for treating heart disease AND diabetes.

Look at the research (again) released just this week and today re: ALL the previous scourges and the result on each with regards to vitamin D supplementation?

Sooner or later everyone will figure it out.

What other possibility, in the nick of time, will reduce chronic disease health costs by 30-40%?

If you are not maintaining 50-80 ng/ml, 25 OH, of vitamin D you'll get sick, in record time.

PERIOD!
ThinkCreeps
Seriously, it's time.
11:40 AM on 06/28/2011
I agree that the `eat less! get off the couch!' treatment sounds cheaper and better.

However, the numbers from the study imply that statin treatment leads to avoiding a heart attack for 1 in 150 patients every year, whereas only 1 in 500 every year becomes diabetic. So, every year your chance of avoiding a heart attack is about three times greater than your chance of becoming diabetic. It's not obvious that avoiding the drugs is necessarily a good decision for the confirmed sedentary community.
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Dana Seilhan
12:00 AM on 06/23/2011
If people would spend less time letting their doctors put them on drugs and more time cutting back on the industrial junk food, this wouldn't even be an interesting topic of discussion.

And doctors are just as much to blame because you should have had the background in biology and biochemistry to know that cholesterol is a necessary substance in the human body and that the last thing you should be doing is reducing it.

I learned a few years ago that you don't even have to be a science major to go to medical school. What the heck is this crap? (Mentally replace the appropriate words with even more appropriate naughty language that'd get me banned here, 'cause that's just what I'm thinking.) You mean to tell me an English major with just enough science classes to meet the minimum standard for medical school might be presuming to give me nutritional or medication advice? After taking (bribes) free pens and free lunches from pharmaceutical reps? Seriously?

We are in so much trouble. People, get your noses out of the TV and crack a book or two. I learned that statins are dangerous completely *outside* of the doctor's office. It's not hard. I promise.
11:47 AM on 06/23/2011
"...the last thing you should be doing is reducing it."

That is ridiculous reasoning. If you had any background in biology and biochemistry you would know that. Just because you need a certain amount of a substance doesn't necessarily mean you can never have too much. In fact, it NEVER means that. Too much of any necessary substance, even water is harmful. Cholesterol is necessary in cellular membranes and for hormonal functions, but stresses the circulatory system, and excessively elevated amounts lead to damage. Just like statins help the heart, but may inhibit some pancreatic functioning. Besides that, humans are capable of manufacturing all the cholesterol they need on their own, so your point is senseless as well.

"you don't even have to be a science major"
Pre-meds have to do very well on the MCATs to get into medical school, so if their pre-reqs don't cover aspects of the material in sufficient detail, they will have to teach themselves effectively or they will get rejected. If they do get in, they then have to spend the next two years learning nothing but anatomy, histology, biochemistry, embryology, etc. Then they will have to pass Step 1 of their licensing exam before they can continue on to their 3rd year.

And undergraduate science classes have almost no relevance to the med school basic sciences curriculum anyways. That is like mocking a chef at a nice restaurant for not having worked at McDonalds in high school.
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Kristin Talbott
One should always be a little improbable.
12:52 PM on 06/23/2011
It's true that you can have too much water, but most people don't take in nearly enough. Which is a good thing for the statin manufacturers, as chronic dehydration causes cholesterol levels to increase.

It's unfortunate that doctors would rather reach for a prescription pad than tell their patients to try doubling (or tripling) their water intake first.
06:54 PM on 07/08/2011
I got accepted into medical school with just one year of biology , three of chemistry , one of physics and one of calculus. What is wrong with that ? If someone gets A s in science from a good college , isn't that better than someone who takes more classes and doesn't do as well at an easier college ?
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Sister Bluebird
08:55 PM on 06/22/2011
I just heard on my local radio station, a drug trial for juvenile or childhood fibromyalgia

Seriously?
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Ranveig Elvebakk
Innovator, author and lecturer on weight and nutri
04:58 PM on 06/22/2011
Bravo, you said it jeffree.There is no money in keeping people healthy. It is tragic but true that 80% of illness in our society is not just unnecessary, it is reversible. Medicine is one of the biggest business ventures in this country, having created us in Frankenstein's image, stitched together by sugar, statins and insulin to the tune of bankrupcy. Politicians with give lip service to "the problem" because their health care is complete and free, doctors are the salespeople of the pharmageddon and know nothing else. Who pays for all of this? Clue: Have you tried to buy health insurance lately??
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littlerabbit
04:42 PM on 06/22/2011
I posted a comment early on, but since I did not agree with the author and statins have helped lower my cholesterol (I am diabetic and tested often) it wasn't posted. I disagree that statins don't do anything. As I regain my health, I would rather have had the help from that drug than nothing -- and still have high cholesterol.
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Dana Seilhan
12:02 AM on 06/23/2011
You don't need to lower your cholesterol. You need to lower your carb intake. What's important in the lipid profile is your triglyceride count, your LDL particle size, and your HDL/LDL ratio. And those are symptoms of underlying problems, not causes of them.

My former stepmother told me the other day that her doctor wanted her to go on a cholesterol-reducing diet. Her total was 218. 200 is normal. I couldn't believe it.
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alykatma
04:27 PM on 07/16/2011
How is your hemoglobin A1C since taking statins. BTW which came first? The diabetes or the statins. I have read that some lifelong diabetics lose control of thier blood sugar once they start the statins, but once they stop the statins, they are able to control their blood glucose again? Google statins and diabetes, lots of info out there.
04:01 PM on 06/22/2011
There is no money in keeping people healthy. Pharmaceutical companies dream is a reality. The reality is an American lifestyle that is full of taking medications.