We have written on several occasions that statins are linked to diabetes. The most recent article was this one: “Statins Cause Diabetes: The Link Just Got Stronger!” Before that we wrote: “Statins and Diabetes | What Happens When Blood Sugar Rises?” Well, we have been severely chastised by one reader. He maintains that one statin, pravastatin (Pravachol), actually lowers blood sugar levels. He also insists that statins protect the brain and prevent dementia and that statins save lives! How good are the data?
Do Statins Protect the Brain?
Q. You have written that statin-type cholesterol-lowering drugs can cause diabetes. You included pravastatin in that list. Historically, it lowers your chances of developing diabetes by 30 percent!
For many people, statins will save their lives. It can also prevent Alzheimer’s disease. Please tell your readers the whole story.
A. For patients with heart disease statins can indeed make a difference. There is quite a bit of controversy, though, about the benefit of statins for people who have not been diagnosed with heart disease (JAMA Internal Medicine, Nov. 15, 2016). We encourage you to read this article. One of the co-authors is a highly regarded cardiologist and editor of JAMA Internal Medicine. Here is just one key observation from this article:
“Using the current data, the decision aid shows that of 100 people who take a statin for 5 years, only 2 of 100 will avoid a myocardial infarction [heart attack], and 98 of the 100 will not experience any benefit. There will be no mortality benefit for any of the 100 people taking the medicine every day for 5 years. At the same time, 5 to 20 of the 100 will experience muscle aches, weakness, fatigue, cognitive dysfunction, and increased risk of diabetes.”
If you would like to read this article, here is a link to:
“Doctors Battle Over High Cholesterol and Blood Pressure”
What About Pravastatin and Lower Blood Sugar?
We understand why you might think pravastatin (Pravachol) might be different than other statins when it comes to diabetes. An old study published in the journal Circulation (Jan. 23, 2001) reported that pravastatin reduced the risk of diabetes by 30 percent.
A new study, however, reports that “use of statins was associated with a 38 percent higher risk of incident type 2 diabetes” (British Journal of Clinical Pharmacology, March 5, 2019). The authors did not find a difference between various statins when it came to the likelihood of developing diabetes.
You can read our in-depth analysis of this recent research at this link:
Will Statins Protect the Brain?
As for preventing Alzheimer’s disease, that too has been controversial. A review of the available literature (Cochrane Database of Systematic Reviews, Jan. 4, 2016) found no credible evidence that statins “prevent cognitive decline or dementia.”
Statin enthusiasts believed that statins protect the brain because of an anti-inflammatory mechanism. But prior research also questioned this theory. A trial of 640 older people with moderate Alzheimer’s disease were randomly assigned to receive either atorvastatin or placebo. The group getting the statin were no better than those on placebo (Neurology, March 23, 2010).
A prior Cochrane analysis also asked whether statins protect the brain (Cochrane Database of Systematic Reviews, April 15, 2009). Here is what the authors concluded:
“There is good evidence from RCTs that statins given in late life to individuals at risk of vascular disease have no effect in preventing AD or dementia. Biologically it seems feasible that statins could prevent dementia due to their role in cholesterol reduction and initial evidence from observational studies was very promising. Indication bias may have been a factor in these studies however and the evidence from subsequent RCTs has been negative.”
What is Your Experience with Statins?
Have you found that statins protect the brain? Do they lower blood sugar levels? Please share your story in the comment section below.