If you search the medical literature for statins and diabetes, you might be surprised at what you find. Many health professionals would prefer that no one ask: do statins cause diabetes? There is tremendous enthusiasm for statin-type cholesterol-lowering drugs such as atorvastatin, lovastatin, pravastatin, rosuvastatin and simvastatin. Anything that rains on the statin parade is distrusted. For example, an article in Current Opinion in Lipidology (June, 2015) concluded: “The clinical impact of statin-associated diabetes is likely unimportant. The cardiovascular risk reduction benefit from statin far outweighs the potential for adverse effects in all but the very lowest risk individuals.” Some doctors still do not believe statins cause diabetes.
Diabetes and Heart Disease:
Here is the problem in a nutshell. People who develop type 2 diabetes:
“…have a two to four times higher risk of developing incident heart disease and ischemic stroke and a 1.5-3.6 times higher chance of dying.” (Cureus, Oct. 2023)
Developing type 2 diabetes is not good for the cardiovascular system!
Do Statins Cause Diabetes or Not?
This is not a question most cardiologists want to answer. There is a disappointing paucity of research devoted to this topic. In fact, the diabetes-statin connection was discovered almost by accident.
Dr. Paul Ridker is a giant in the field of cardiology. He and his colleagues published a landmark study called JUPITER in the New England Journal of Medicine on Nov. 20, 2008. They were focused on something called high-sensitivity C-reactive protein (HS-CRP). They believed that this inflammatory marker was important in heart disease and hoped that rosuvastatin (Crestor) would lower HS-CRP and major cardiovascular events. Over 17,000 volunteers participated in the JUPITER trial.
The researchers were thrilled that after nearly two years they could report that in healthy people:
“…without hyperlipidemia but with elevated high-sensitivity C-reactive protein levels, rosuvastatin significantly reduced the incidence of major cardiovascular events.”
The only fly in the ointment was that:
“The rosuvastatin group…did have a higher incidence of physician-reported diabetes.”
The authors of the JUPITER trial went on to acknowledge:
“Increases in glucose and glycated hemoglobin levels, the incidence of newly diagnosed diabetes, and worsening glycemic control have been reported in previous trials of pravastatin, simvastatin, and atorvastatin.”
Even though there were previous reports of elevated glucose levels and HbA1C associated with statin use, it was the JUPITER trial that cracked open the safe on statins and diabetes. It was embarrassing.
Other Research Linking Statins to Diabetes:
A study published in Diabetes Metabolism Research and Reviews (May 24, 2019) analyzed data from more than 7,000 patients. They compared statin takers with non-statin takers. The researchers looked at elevations in hemoglobin A1c (HbA1c) which is a measurement of sugar metabolism over time. They also tracked new-onset-diabetes (NOD).
Statin users were more than twice as likely to develop NOD as nonusers. The authors note that:
“Those taking statins for 2 years or longer (AHR=3.33, p<0.001) were at the greatest risk of developing NOD; no differences were observed by statin class or intensity of dose.”
In our opinion, statins cause diabetes. The longer the drugs are taken, the the greater the risk!
Not the First Time!
Researchers are very cautious about how they describe the relationship between statins and diabetes. A study published in Therapeutics and Clinical Risk Management (May 3, 2018) reviewed data on 68,000 patients (21,551 statin patients and 46,442 nonusers).
The conclusions:
“Our study indicated an association between statin use and an increased risk of new-onset diabetes mellitus.”
A study published in The Consultant Pharmacist (vol. 29(5), 2014) tiptoed around this issue:
“Review of current, available clinical data suggest a possible association between statin use and incident diabetes in patients with underlying diabetes risk factors.”
A meta-analysis of studies published in Cardiorenal Medicine (Vol. 8(2), 2018) reported that:
“statin therapy is associated with NODM [new-onset diabetes mellitus], such that there is a small but significant risk of NODM among patients receiving statin for CVD [cardiovascular disease] prevention therapy.”
Research published in the British Journal of Clinical Pharmacology (March 5, 2019) confirmed the connection:
“Individuals using statins may be at higher risk for hyperglycaemia, insulin resistance and eventually type 2 diabetes.”
That study involved 9,535 people who did not have diabetes before starting statins. You can read more about this research and other studies at this link:
A More Recent Review Also Asks: Do Statins Cause Diabetes?
A review of the medical literature in the journal Clinics and Practice (Aug. 2022) concludes:
“The elevation in the glycemic parameters is evident among statin users compared to non-statin users, which signifies statin users may have nearly double the risk of developing diabetes than non-statin users.
“It has been found that statin users without dyslipidemia have increased insulin resistance as compared with statin users with dyslipidemia. From the data, it is also clear that increasing the consumption of statins will simultaneously increase the risk of developing diabetes.”
Diabetes Is NOT a Trivial Side Effect:
Virtually every medical report we have read that suggests that the idea statins can cause diabetes comes with a caveat. The risk is “small.” Very few researchers suggest that anyone should stop a statin because of diabetes.
Even the FDA is on record saying:
“…the risk of developing diabetes as a result of a statin is small. ‘The benefits of statins in reducing heart attacks and strokes should generally outweigh this small increased risk.”
People’s Pharmacy Perspective:
The weight of the evidence is reaching a tipping point. We think that saying statins are “associated with diabetes” or “statins are linked to diabetes” are misleading. We think it is past time for clinicians to come right out and say “statins cause diabetes.”
Diabetes can cause heart disease, strokes, hypertension, neuropathy (nerve damage), eye problems, digestive tract issues, foot complications, kidney disease and a whole lot more. We do not think the refrain “Don’t Worry, Be Happy” is appropriate when people develop diabetes as a result of taking statins (although it is a wonderful song).
A Reader Describes Diabetes and Muscle Cramps While on Statins:
Q. Ten years ago, I was on a statin and developed diabetes. I needed insulin to control my blood sugar, but nothing helped the terrible muscle cramps in my legs.
After years on various statins, I got off them and the cramps went away. I took up bicycle riding seriously, and now ride 33 miles or more two or three times a week. My endocrinologist helped me lose nearly 50 lbs. I no longer eat potatoes, corn or French fries. Best of all, I’m no longer diabetic and need no diabetes meds whatsoever.
A. The first statin, Mevacor (lovastatin), was approved in 1987. It wasn’t until a study was published in the New England Journal of Medicine (Nov. 20, 2008) that physicians got an strong inkling that cholesterol-lowering drugs like rosuvastatin could raise blood sugar.
Many physicians believe that the benefits of statins far outweigh the risk of developing diabetes. But this metabolic disorder causes many serious complications. The evidence for a link with statins has become stronger over the years.
Exercise and weight loss, as you have demonstrated, are well-established methods for getting blood glucose under control. People who would like to learn about a variety of non-drug approaches may wish to consult our eGuide to Preventing & Treating Diabetes. This online resource is found under the Health eGuides tab.
We absolutely recognize that some people should take statins. Those with diagnosed heart disease appear to benefit the most. But people who do not have heart disease and are taking statins for prevention may need to have a heart-to-heart with a physician about the diabetes risk if their blood glucose levels or HbA1c levels start rising.
Here is an article we wrote on this topic that you might find relevant:
Statins and Diabetes | What Happens When Blood Sugar Rises?
What do you think? Please share your perspective or story about statins and diabetes in the comment section.
