The Columbus Dispatch

Benefits of statin medication outweigh higher sugar level

- DR. KEITH ROACH Dr. Roach answers letters only in his North America Syndicate column but provides an order form of available health newsletter­s at www.rbmamall.com. Write him at 628 Virginia Dr., Orlando, FL 32853-6475; or ToYourGood­Health@ med.cornell.ed

I am a 65-year-old female with a family history of diabetes.I am on a statin (Lipitor) for high cholestero­l, and I recently was told after blood tests that I am prediabeti­c (A1C of 6.4).

I cut out all sugar and white flour, and my A1C dropped to 6.2. My doctor retired, and I stopped taking Lipitor for three months. When I saw a new doctor, my cholestero­l, of course, was up (from 203 to 349) because of stopping the statin — but my A1C had dropped to 5.8 despite the fact that I did not watch my diet at all during those three months.

Now I am afraid that the medication is causing my prediabete­s and keeping my sugar elevated. My cholestero­l is high without a statin, despite efforts to exercise and watch my diet, so I can’t do without it. I seem to be caught in a vicious cycle with the higher A1C. Are there other statins that do not raise blood sugar?

It is true that statin drugs can increase blood-sugar levels. On average, fasting sugar levels in nondiabeti­cs rose about 7 points (from 98 to 105) in a review of 350,000 people studied. In people who already are prediabeti­c, that small amount can mean the difference between prediabete­s and diabetes.

To answer whether you should be on a statin, you and your physician should compare the increase in risk of heart disease and stroke — in tandem with blood-sugar levels — against the benefit of lowering cholestero­l (most experts feel that statins have additional benefits beyond their effect on cholestero­l).

In looking at the numbers you provided, the combinatio­n of careful diet and Lipitor reduced your cholestero­l a dramatic 146 points, but your A1C went up somewhere between 0.4 and 0.6 points. It would seem that the benefit of lowering the cholestero­l far outweighs the risk from higher sugar.

My advice would be to do both: the dietary changes you mentioned (and even modest exercise — a half-hour a day helps) — and the Lipitor together would be best for your overall health. However, your new doctor should keep a very careful eye on it and treat you if necessary.

What is the current thinking regarding aluminum in antiperspi­rants causing an increased risk of breast cancer?

I reviewed the literature on aluminum in antiperspi­rants and the risk of breast cancer, and my opinion is that there is no convincing evidence of increased risk. The U.S. National Cancer Institute reviewed the available studies in 2016 and concluded that “no scientific evidence links the use of these products (deodorants and antiperspi­rants) to the developmen­t of breast cancer.”

— I.S. Answer: — A.F.

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