Lipitor Linked To Increased Diabetes Risk
More evidence has linked the cholesterol-lowering drug Lipitor to an increased risk of type 2 diabetes, especially in patients who have multiple diabetes risk factors, according to a study published on Monday.
A number of previous studies have linked Lipitor and other cholesterol medications (statins) to a small increase in the risk of diabetes. And the new study, based on data from three large clinical trials, further supports that connection.
But the new study also suggests the risk might exist more in people who also have other risk factors for type 2 diabetes — which include obesity, high blood sugar, elevated triglycerides and high blood pressure.
Dr. David D. Walters, of the University of California at San Francisco, told Reuters Health by email that the four factors appear “very good at distinguishing people at high or low risk for developing new-onset diabetes with atorvastatin.”
So, said Waters, managing those risk factors is important for reducing the extra diabetes risk. He also stressed that the diabetes risk tied to cholesterol drugs is small.
“An important point is that the risk of developing new-onset diabetes and its complications (is) greatly outweighed by the benefit of statins in reducing cardiac death, heart attack and stroke,” said Waters.
The findings are based on three clinical trials that compared high-dose atorvastatin with either a lower dose statin or placebo pills in people with cardiovascular disease.
In one trial, the study found that atorvastatin users had a higher risk of developing type 2 diabetes over 5 years (9 percent) than those who used the placebo (6 percent).
The trial included 3,800 adults who did not have diabetes at the start, but all had a history of stroke or “mini” strokes known as transient ischemic attacks.
When the researchers accounted for age, weight and smoking habit factors, atorvastatin use was linked to a 37 percent increase in the odds of developing diabetes, versus those using the placebo.
But the study also showed that the extra risk appeared limited to patients with at least two of the four major risk factors for diabetes.
Almost half of atorvastatin users with all four risk factors developed diabetes, compared to only 20 percent of the placebo group.
In the other trials, the team found no major connection between high-dose atorvastatin and risk of diabetes.
Diabetes risk is not limited to only statin drugs. Certain high blood pressure beta-blockers and thiazide diuretics, niacin and glucocorticoids have also been linked to an increase in the risk of diabetes.
In most of those cases, the reason for the increased risk appears to be the effect the drug has on the body’s ability to control blood sugar.
But it is not yet understood why statins contribute to a higher diabetes risk, said Waters.
While it should be wise for doctors to carefully follow atorvastatin users, the team said the benefits of the drug “clearly outweigh” the risks for people with heart disease and stroke. People with no heart disease or prior to stroke may be better off to first try dieting and exercising for lowering cholesterol.
Waters and other colleagues involved in the study have financial ties to Pfizer Inc. — the maker of Lipitor. Three of the researchers are employees of Pfizer as well.
The study is published in the Journal of the American College of Cardiology.
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