As reported by a 2020 US Department of Health and Human Services study, in 2018, 34.1 million American adults were living with diagnosed or undiagnosed diabetes. Men and non-Hispanic white individuals represented the majority of these diabetes cases.

Just two years later, according to the Centers for Disease Control and Prevention, the number of adults living with diabetes, both diagnosed and undiagnosed, increased to 37.3 million. Moreover, 96 million people aged 18 and above are prediabetic, which translates to 38% of the American adult population.

This data suggests that diabetes has reached epidemic levels in the United States. A study published in the British Journal of Clinical Pharmacology noted that adults using statin drugs to regulate cholesterol levels demonstrated a heightened risk of developing insulin resistance and type 2 diabetes compared to the general population. However, no concrete evidence has been found linking high cholesterol levels to cardiovascular disease risk.

As discussed in previous articles, three factors significantly affect the risk of cardiovascular disease, often being interconnected. These factors are insulin resistance, chronic inflammation, and elevated iron levels. Regrettably, conventional medicine practitioners tend to overlook these contributing factors in the prevention and treatment of cardiovascular disease.

Statins, or cholesterol-lowering medications, are the primary treatment strategy in Western medicine and are often deemed the most cost-effective drug. Dr. Malcolm Kendrick, a general practitioner in Cheshire, England, and author of three books, including “Statin Nation: Damaging Millions in a Brave New Post-Health World,” estimates that the pharmaceutical industry has made over a trillion dollars from statins.

Statins Elevate Diabetes Risk by 38%

A study published in the British Journal of Clinical Pharmacology by a team from the Erasmus University Medical Center in the Netherlands demonstrated a correlation between statin use and diabetes. The study focused on blood sugar traits related to type 2 diabetes.
The Rotterdam study included 9,535 non-diabetic participants. Over 15 years, they discovered that statin users had higher fasting serum insulin concentrations and insulin resistance than non-users.

This resulted in a 38% increased risk of developing type 2 diabetes. The researchers concluded that statin users could face an increased risk of developing hyperglycemia, insulin resistance, and consequently, type 2 diabetes. Preventive strategies such as maintaining blood glucose levels and weight loss upon initiating statin therapy could help reduce diabetes risk.

The specific mechanism by which statins trigger type 2 diabetes remains unidentified and may not be linked to obesity. Scientists have identified a condition called metabolic obesity with normal weight (MONW), a subset of the population that develops insulin sensitivity and an elevated risk of diabetes despite being of normal weight.

Recent research has also found that people taking statin drugs have a higher risk of developing type 2 diabetes. Scientists have suggested various reasons for this increased risk, including insulin sensitivity and reduced insulin secretion from pancreatic beta cells. An article published in the International Journal of Molecular Science reviewed the mechanisms by which statins appear to increase risk, including microRNA differential expression’s impact on epigenetics.

Another study compared DNA methylation in statin users versus non-users, concluding that DNA methylation contributes to statins’ effect on insulin traits.

Statins also Amplify the Risk of Cardiovascular Events

A third retrospective cohort study analyzed the outcomes of 13,698 patients categorized into statin and non-statin users. The study began in 2005, with participants initially free of atherosclerotic cardiovascular disease or diabetes. They tracked the group until 2013, evaluating the risk of type 2 diabetes. Results indicated that compared to non-statin users, statin users had a higher risk of new-onset type 2 diabetes. The researchers segregated the risk by different statin medications and found that a five-year usage of simvastatin (Zocor), followed by atorvastatin (Lipitor), was associated with an increased risk.
Amidst the peak of the pandemic in January 2021, a study published in the journal Atherosclerosis revealed that individuals taking statins experienced a higher rate of cardiovascular incidents. This finding is noteworthy as statins are intended to decrease the rate of such events.

The researchers utilized a coronary artery calcium (CAC) score, a noninvasive CT scan designed to detect plaque accumulation in the coronary arteries. This score, also known as the cardiac calcium score, bone scan, or Agatston score, is generally used to calculate the risk of developing coronary artery disease. The investigators hypothesized that statins might enhance calcification and sought to investigate the significance of predicting CAC scores with statin use.

They compared 28,025 patients aged 40 to 75 who were taking statins, and about 11 months after the results were published, Tucker Goodrich rendered the raw data into a graphical representation. Only in the higher CAC scores of 400 or more were the data nearly identical between statin users and non-users. Otherwise, statin users experienced more cardiovascular events than non-users.

The investigators concluded: “The CAC score remains a risk predictor in statin users, and the changing relationship of CAC density to outcome might explain the weaker relationship of CAC to outcome in statin users.”

The researchers acknowledged that only one baseline CAC score was known, so they couldn’t assess whether statins influence how calcification progresses. Scores ranged from zero to over 400, with zero representing no plaque and lower risk of heart attack, 100 indicating patients with mild heart disease and moderate risk of heart attack, and the range from 101 to 400 representing moderate amounts of plaque that could block a coronary artery.

Despite the raw data, some have suggested that patients should have more than one CAC score despite exposure to the same radiation as 10 X-rays, as the information could bias study results to show that statins had some benefits and decreased calcified plaque. However, this could not alter the figures showing that people taking statins died more frequently than those not taking them.

Erroneous Evidence Boosts Pharma Profits

In a 2018 peer-reviewed narrative titled: “Statin Wars: Have We Been Misled About the Evidence?” and published in the British Journal of Sports Medicine, Maryanne Demasi, Ph.D., an investigative health reporter, delves into some of the controversies.
Though Demasi’s article requires a fee to access, she reviews her arguments in a presentation at the University of Sydney. Among them is the claim that the “statin empire” is based on prescribing these drugs to people who don’t necessarily need them and are likely to experience side effects without benefit.

Several outlandish recommendations have been proposed, such as prescribing statins to everyone over 50, regardless of cholesterol levels, testing and formulating dosages for young children, and even adding statin drugs to fast food or municipal water supplies.

Medical professionals are now divided into two camps: those who advocate for statins as life-saving and safe for everyone, and those who consider them unnecessary and harmful. Such a divide arises even though everyone has access to the same research and data.

Demasi suggests that economic issues must be considered to understand this divide. The cost of developing and gaining market approval for a new drug exceeds $2.5 billion. “The best way to boost company profits is to expand the indications of an existing drug,” she states, and this is what occurred with statins.

After redefining “high cholesterol,” the pharmaceutical industry expanded the patient pool for statins enormously. Today, it’s not uncommon for individuals with cholesterol levels considered normal a few decades ago to be prescribed statins.

Furthermore, Demasi highlights the selective reporting of trial data by pharmaceutical companies. Many studies only report relative risk reductions, which are more impressive sounding than absolute risk reductions. For example, a drug that reduces the risk of heart attack from 2% to 1% in a five-year period can be said to reduce the risk by 50% (relative risk reduction) or by 1% (absolute risk reduction). The former sounds far more impressive, even though the two figures describe the same outcome.

She also mentions the issue of publication bias. Negative studies, or those showing no benefit or potential harm from statins, are less likely to be published than those showing positive effects. This distorts the overall understanding of the efficacy and safety of statins.

Reassessing the Role of Statins

Given the potential side effects and the mixed evidence regarding their efficacy, some medical professionals and researchers have begun to question the widespread use of statins. The focus on lowering cholesterol levels might be misplaced, they argue, given that half of those who suffer heart attacks have normal cholesterol levels.

Instead of focusing on cholesterol levels, these critics suggest, doctors should pay more attention to inflammation, which plays a key role in heart disease. Lifestyle modifications, such as a healthier diet, regular exercise, and stress reduction, can effectively reduce inflammation without the need for medication.

The debate about statins is far from settled. But it’s clear that a careful, individualized approach to prescribing these drugs, taking into account each patient’s unique risk factors and circumstances, is needed. As always, patients should be fully informed about the potential benefits and risks of any medication they are considering.