Statins can increase blood sugar levels
Dr. Keith Roach
Question: Iama 65-year-old female with a lot of diabetes in my family. 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. I lost my doctor and stopped taking Lipitor for three months. When I saw a new doctor, my cholesterol of course was up (from 203 to 349) due to 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? What can I do to get out of this Catch-22 situation? — I.S.
Answer: It is true that statin drugs can increase the 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. As far as I know, all statin drugs can cause this small increase in blood sugar.
Your question is one of competing risks. To answer whether you should be on a statin, we need to compare the increase in risk of heart disease and stroke from increasing blood sugar 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 it looks like your A1C went up somewhere between 0.4 and 0.6 points. It’s difficult to compare those directly, but most models would suggest 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. I think you can manage your diabetes risk with diet and exercise; however, your new doctor should keep a very careful eye on it and treat you if necessary.
Q: In a recent column, you stated that “it is no longer thought that using aluminum utensils or cookware affects Alzheimer’s risk.” What is the current thinking regarding aluminum in antiperspirants causing an increased risk of breast cancer? — A.F.
A: 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.