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Sunday, November 21, 2010

New Study Confirms Statins Cause Diabetes

New Study Confirms Statins Cause Diabetes


Wednesday, February 17, 2010 at 06:55PM

The results of a new study have just been published in The Lancet. The researchers found that statins increase the risk for diabetes. This increased risk seems very small - its 0.4 percent. However, this is more significant than it may first seem.

The authors of the published report have stated that the benefits of statins still far outweigh the risks. But do they?

When looking at the 'benefits' of statins, we should look at how many lives are actually saved by the drugs. The JUPITER trial, which has recently been used to justify the wider use of statins, showed that statins reduce deaths from all-causes by only 0.55 percent.

This mere 0.55 percent reduction in deaths is not even the worse case scenario. Since other trials, such as the AFCAPS trial, the ASCOT trial, and the CARDS trial, all failed to show any significant reduction in deaths from all causes.

Strictly speaking, deaths from all-causes is the most important measure we should use to judge the effectiveness of a drug. Since there is not much point if the drug reduces the risk for one disease but at the same time increases the risk for another disease within the same time period. But 'experts' often focus on the cardiovascular benefits of statins in order to make the drugs appear to be better than they actually are.

Even if we do just look at cardiovascular benefits, the results are certainly nothing to shout about. The JUPITER trial mentioned above found that statins reduce the risk for ‘hard cardiac events’ (heart attack, stroke, or death from cardiovascular causes), by just 0.9 percent.

Statins can be more effective when used by people who already have heart disease. But even here the benefits in terms of actual lives saved have been mixed. And most people who take statins are at a low risk of developing heart disease.

So, when we put the 'benefits' of statins into context we can see that this increase in diabetes is by no means trivial. Any increase in diabetes should be of concern, since diabetes drastically increases the risk for heart disease, and the full extend of these risks would not be seen during a statin clinical trial. This is because statin trials are only 2 to 6 years in duration – the full extent of the increased risks associated with diabetes develop over a much longer period of time.

And we have not included in this discussion the long list of other officially recognised adverse effects associated with statins. Or the significant questions that still remain concerning statins and cancer, and statins and heart failure.

There are no published studies to show that statins provide any benefit after 5 or 6 years, yet millions of people are being asked to take the drugs for several decades. The best case scenario is that any net benefit associated with statins hangs on a knife edge. Despite this, in the UK alone, we spend hundreds of millions of pounds on these drugs every year.

There is no need for pharmaceutical companies to worry about the increased risk for diabetes associated with statins, since they have other (equally ineffective) drugs for that as well.

Note: I have used absolute percentages for this discussion. In most cases, relative percentages are used in summary reports and throughout the media. All text books on clinical research advise against the use of relative percentages in this context since relative percentages are totally misleading and do not allow people to make accurate comparisons of risk.

Reference:


Sattar N, et al. Statins and risk of incident diabetes: a collaborative meta-analysis of randomised statin trials. Lancet 2010; DOI:10.1016/S0140-6736(09)61965-6

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