Statins for all diabetics urged

[Al-khiyal]

Statins for all diabetics urged

January 11, 2008 -- People with diabetes should receive cholesterol-busting drugs regardless of whether they have signs of heart disease, UK researchers say.

Statins cut the risk of heart attack, stroke and death in diabetic people even in those with low cholesterol levels, analysis of 14 trials shows.

It means hundreds of thousands more people could benefit from treatment, the Lancet report said.

There are 2.5 million people diagnosed with diabetes in the UK.

Many more do not realise they have the condition and statins are "underused" in people with diabetes the researchers said.

Guidance from the National Institute of Clinical and Health Excellence (NICE) in England and Wales issued in 2006 estimated around 3.3 million people are eligible for treatment with statins.

This includes people with diabetes who have a 20% risk of developing cardiovascular disease in the next 10 years.

A team of researchers at Oxford University reviewed studies of more than 90,000 people - 19,000 with diabetes - and found that many more would benefit from statins than previously realised.

They found that standard daily treatment with statins would prevent about one third of heart attacks and strokes in people with diabetes.

The benefits were seen regardless of age, sex and whether patients were already showing signs of cardiovascular disease.

After five years, 42 fewer people with diabetes had major problems, such as heart attacks or stroke, for every 1,000 treated with statins.

The only exceptions for treatment should be those with exceptionally low risk, such as children or those who cannot take the drugs for other reasons, such as pregnant women.

Study leader Professor Colin Baigent said there had been some debate about whether statins would have the same benefits in people with diabetes as those with heart disease in general.

"People with diabetes are a clearly defined group of people at an increased risk of cardiovascular disease.

"What we're saying is statins are clearly effective in every type of person with diabetes."

Diabetes UK estimates 60% of all diabetics currently receive statins. That would mean the vast majority of the remaining 40% could also benefit from these drugs, according to the researchers.

However, Douglas Smallwood, chief executive of Diabetes UK, recommended statins for people with diabetes over the age of 40 or diabetics younger than 40 with another risk factor.

"Diabetes UK also strongly recommends that good diabetes management should rely not only on medication, but also on a healthy lifestyle and diet," he added.

[amalgamate]

If I were a healthy diabetic and could choose between taking pills daily or not, I'd choose not to get myself dependent on any statin drugs unless otherwise necessary.

really, who'd just want to take drugs for the heck of it? Vitamins I understand, but drugs??

[Al-khiyal]

really, who'd just want to take drugs for the heck of it? Vitamins I understand, but drugs??

From the article:

"Statins cut the risk of heart attack, stroke and death in diabetic people even in those with low cholesterol levels, analysis of 14 trials shows."

[amalgamate]

When you have no risk, cutting the risk is a minuscule benefit.

Comparing the pros vs cons:
The problem here is that once you are on medication and take it for a time, the body gets used to it and any alterations or abuse of the pattern of taking the drug, causes other complications to arise.

What initially drives a healthy individual to be 'healthier' by taking these drugs, increases the chances falling into the role of mal use of the drug and addiction.

One of the biggest problem with patients who keep coming back for more is that they don't take the medication correctly or follow doctors orders of proper diets and exercise. Legal drug abuse is a common dilemma.

It's a large hole one might fall into when dealing with drugs,

If one is healthy, I recommend they not take drugs.

besides, the news one gets from scientific studies should NOT swiftly get them convinced. A lot of studies are backed by drug companies that their sole goal is to get society to rely on drugs to keep the pharmaceutical industry booming.

-just some things to keep that in mind when hearing about such new 'breakthroughs'.

[Al-khiyal]

What I understand the article to mean, and the deductions made by the researchers upon whose work it is based, is that there evidently is a risk of diabetics developing some of the further complications listed, but that taking statins would reduce the risk. So a 'stable diabetic' of today may still be at risk of suffering heart attacks or strokes at some point in the future - but taking statins would be some kind of insurance against that happening.

[amalgamate]

Reducing the risk of future complications in healthy diabetics is greatly dependent upon diet and exercise routine. Statins could reduce the risk as the studies show, but scientists would never attempt to say that keeping up a healthy eating habit or including regular exercise in one's daily schedule also reduces those risks just as effectively maybe even more. For scientists, that's all for dieticians to say.

Even the widely used drug, Viagra has diet alternatives! but large drug companies don't want their costumers to know that.

These days, I've noticed that there are more and more medications arising that are not necessarily for the sick but now for the healthy!

The way I see it, it basically all boils down to whether one healthy individual would like to dive into the world of drugs and their endless complications or not.

[amalgamate]

Health Guide: Statins
The New York Times
Monday Jan 14, 2008

Statins are the most effective drugs for the treatment of high cholesterol, and may even prove important drugs for many people at risk for heart disease who have normal cholesterol levels.

Beneficial Effects on the Heart and Circulation. Statins are particularly effective for lowering LDL levels. They also reduce triglycerides, apparently in direct proportion to their LDL-lowering effects. Statins also raise HDL levels, but to a lesser extent than other anti-cholesterol drugs. (The newer statins appear to produce more significant increases in HDL.) Evidence now strongly suggests that statins may offer other health benefits beyond lowering cholesterol:

*Statins may improve the function of the endothelium (the lining of blood vessels), thereby improving blood flow. (This benefit apparently does not extend to people with diabetes.)
*Statins appear to reduce inflammation in the arteries, which is now believed to be a major factor in blood vessel injury.
*Some evidence suggests that statins may help prevent blood clotting, a major factor in heart attacks.


Beneficial Effects Outside the Heart.
Studies also suggest that the benefits of statins go beyond the heart. At this time, nearly all studies on the following conditions have used natural statins:

Stroke. Statins may reduce the risk for ischemic stroke in high-risk patients with a wide range of cholesterol and lipid levels. (Ischemic strokes occur from blockage in the blood vessels that lead to the brain.) In 2003, statin therapy was shown to reduce both fatal and non-fatal stroke in patients with hypertension and at least three additional cardiovascular risk factors. A 2004 study of stroke patients found that those who were receiving statin therapy at the time of their stroke had more favorable long-term outcomes than patients who were not on statin therapy, suggesting that statin therapy may provide additional benefits to patients who develop stroke.

Diabetes. Statins may have a number of effects that are helpful for patients with diabetes, and may even prevent diabetes in some people with high cholesterol. Statins, however, do not appear to have any effect on blood vessel inflexibility in diabetes, which is an important risk factor for heart disease in these patients. A major 2003 study found that statin therapy helped prevent cardiovascular events including coronary death, heart attack, stroke, and the need for revascularization therapy in patients with diabetes, even in those who did not have high cholesterol levels or established coronary disease.

High Blood Pressure. In an important 2002 study, patients with high blood pressure but normal hMG-CoA reductase or slightly high cholesterol levels had fewer heart attacks and strokes when they took the statin atorvastatin. The study was stopped so all subjects could take statins. An earlier study showed similar benefits with the statin simvastatin.
Alzheimer's Disease. A number of studies have reported a significantly lower risk for Alzheimer's disease in people who take specific statins. Some evidence suggests they may even improve mental function in people without unhealthy cholesterol levels. Statins showing the greatest promise include lovastatin (Mevacor), pravastatin (Pravachol), and atorvastatin (Lipitor.) These statins appear to reduce levels of beta-amyloid. Other statins have not been associated with a lower risk for Alzheimer's. In fact, some researchers are concerned that certain statins that cross the blood-brain barrier may actually worsen Alzheimer's in people who already have it.

Kidney Disease. Statins may prove to protect against heart disease development in patients with mild kidney disorders. According to a 2004 study, statins may also help slow the progression of existing kidney disease.

Adverse Effects.
The statins tend to be better tolerated than other cholesterol-lowering drugs. In many studies the side effects reported were nearly the same as those taking placebo. Side effects may include gastrointestinal discomfort, headaches, skin rashes, muscle aches, sexual dysfunction, drowsiness, dizziness, nausea, constipation, and peripheral neuropathy (numbness or tingling in the hands and feet).

The primary safety concern with statins has involved an uncommon condition called myopathy, which can cause muscle damage and in some cases, muscle and joint pain. A specific myopathy, called rhabdomyolysis, can lead to kidney failure. Reports of rhabdomyolysis prompted the recall of cerivastatin (Baycol) in 2001. The risk for myopathy/rhabdomyolysis is highest at higher doses and in older people (over 65 years), those with hyperthyroidism, and those with renal insufficiency (kidney disease). Both statins and fibrates carry a risk for myopathy. The combination of the two drugs increases this side effect. Some people who use a statin-fibrate combination withdraw from the regimen because of muscle discomfort.

In 2005, the FDA issued a public health advisory for rosuvastatin (Crestor), noting that this drug, like other statins, increased the risk for myopathy and rhabdomyolysis. The risks were greatest at the highest dose level (40 mg). The FDA advises that patients should not start therapy at this dose. In addition, the FDA reported the results of a post-marketing study that found that people of Asian heritage had twice the blood levels of the drug as Caucasians who had taken the same dose. Because of this difference in drug metabolism, the FDA advises that Asian Americans should start treatment at the lowest rosuvastatin dose (5 mg). In general, all statin therapy should start at a lower dose and be raised incrementally until healthy cholesterol levels are maintained. Patients should immediately tell their doctor about any unusual muscle discomfort or weakness, fever, nausea or vomiting, or darkening of urine color.

Statins can also affect the liver, particularly at higher doses, so patients should have periodic liver function tests. Statins should not be taken by anyone with liver problems or by women during pregnancy or breast-feeding. Similarly, high statin doses increase the risk for kidney failure, particularly for patients with other existing risk factors (diabetes, hypertension, atherosclerosis, history of heart failure).

Interactions with Drugs and Food.
Statins may have some adverse interactions with other drugs, including other cholesterol-lowering medications. Among the drugs that increase the risk for adverse effects are cyclosporine, macrolide antibiotics, and certain antifungals. Patients should tell their doctors about any other medications they are taking. Grapefruit juice and Seville oranges may increase statin potency.