Statins and diabetes mellitus are currently widely researched and hotly debated by scientists from around the world. Many studies that used the placebo effect were able to prove that statins significantly reduce the risk of developing a cardiovascular disease.
At the same time, there are a number of observations pointing to the fact that statins in type 2 diabetes can increase the risk of disease. In particular, diabetics have an increase in blood sugar, which means that they have to take Metformin or switch to Sartans.
Meanwhile, many doctors continue to prescribe medications for diabetes. How true are such actions of physicians and whether it is possible for patients with diabetes to take statins?
Cholesterol is a natural chemical compound that is involved in the production of female and male sex hormones, provides a normal level of fluid in the cells of the body.
However, with its overabundance in the body can develop a serious disease – atherosclerosis. This leads to disruption of the normal operation of blood vessels and often causes severe consequences, because of what a person can suffer. The patient usually has hypertension due to the accumulation of cholesterol plaques.
Statins are pharmacological drugs that reduce blood lipids or cholesterol and low-density lipoproteins – the transport form of cholesterol. Drugs of therapy are synthetic, semi-synthetic, natural, depending on their type of origin.
The most pronounced hypolipidemic effect is atorvastatin and rosuvastatin of synthetic origin. Such drugs have the most evidence base.
The first thing statins suppress enzymes that play a major role in the allocation of cholesterol. Since the amount of endogenous lipids at this point is up to 70 percent, the mechanism of drug exposure is considered to be the key in eliminating the problem.
Also, the drug promotes an increase in the number of receptors to the transport form of cholesterol in hepatocytes. These substances can catch lipoproteins that circulate in the blood, and transpose them into the liver cells, where the process of removing the waste products of harmful substances from the blood takes place.
Including statins do not allow fats to be absorbed into the intestines, because of which the level of exogenous cholesterol decreases.
In addition to the basic useful functions, statins have a pleiotropic effect, that is, they can act immediately on several “targets”, improving the general state of a person. In particular, the patient taking the above described drugs experiences the following health improvements:
- Improves the condition of the inner shell of blood vessels;
- The activity of inflammatory processes decreases;
- Prevents formation of blood clots;
- Spasms of the arteries supplying the myocardium with blood are eliminated;
- In the myocardium, the growth of the renewed blood vessels is stimulated;
- Myocardial hypertrophy decreases.
That is, we can safely say that statins have a very positive therapeutic effect. The doctor chooses the most effective dosage, while even the minimal dosage is able to have a therapeutic effect.
The greatest benefit is the smallest number of side effects in the treatment of statins.
Today, many physicians believe that lowering blood cholesterol in type 2 diabetes is an important step towards recovery. Therefore, these drugs, like the Sartans, are prescribed on a par with medicines such as Metformin. Including statins are often used even with normal cholesterol to prevent atherosclerosis.
The drugs of this group are distinguished by their composition, dosage, side effects. The last factor doctors pay special attention, so the therapy is conducted under the supervision of a doctor. Next, several types of drugs for lowering cholesterol in the blood are indicated.
The drug Lovastatin is produced using molds that pass through the fermentation process.
A similar drug is the drug Simvastatin.
Also has a similar composition and action drug Pravastatin.
To fully synthetic drugs include Atorvastatin, Fluvastatin and Rosuvastatin.
The most effective and widely used drug is rosuvastatin. According to statistical data, the cholesterol in the human blood after treatment with such a drug for six weeks is reduced by 45-55 percent. The least effective medicine is Pravastatin, it lowers the cholesterol level by only 20-35 percent.
The cost of the preparations is significantly different from each other, depending on the manufacturer’s firm. If 30 tablets of Simvastatin can be bought at a pharmacy for about $ 50, the price for Rosuvastatin varies from 200 to 600 dollars.
The first treatment effect can be achieved no earlier than a month after regular medication. Following the results of therapy, the production of cholesterol by the liver decreases, the absorption of cholesterol from the received products decreases in the intestines, the already formed cholesterol plaques in the cavity of the blood vessels are eliminated.
Statins are indicated for admission when:
- heart disease, the threat of heart attacks;
- diabetes mellitus, to prevent or reduce complications associated with blood circulation.
Sometimes the appearance of atherosclerotic plaques can be observed even at low cholesterol values.
In this case, the drug can also be recommended for treatment.
Diabetes mellitus and cardiovascular diseases
With diabetes, there is a high risk of negative consequences in the work of the cardiovascular system. In diabetics, the probability of developing heart pathologies is five to ten times higher than in people with normal blood sugar levels. In 70% of such patients, due to complications, a lethal outcome is observed.
As noted by the representatives of the American Heart Association, people with diabetes mellitus and those diagnosed with ischemic disease have an absolutely identical risk of death due to a cardiovascular catastrophe. Thus, diabetes is no less serious than CHD.
According to statistics, coronary heart disease is detected in 80 percent of people with type 2 diabetes. In 55 percent of cases in such people, death occurs due to myocardial infarction and in 30 percent – because of a stroke. The reason for this is the presence of specific risk factors in patients.
To such risk factors in diabetics can be attributed:
- Increased blood sugar;
- The emergence of insulin resistance;
- Increase in the concentration of insulin in the blood of a person;
- Development of proteinuria;
- Increase in the sharp fluctuations in glycemic parameters.
In general, the risk of developing cardiovascular diseases increases with:
- burdened heredity;
- a certain age;
- the presence of bad habits;
- insufficient physical activity;with arterial hypertension;
- diabetes mellitus.
An increase in the concentration of cholesterol in the blood, a change in the number of atherogenic and anti-atherogenic lipids are independent factors that increase the risk of developing cardiovascular diseases. As shown by various scientific studies, after the normalization of these indicators, the probability of the appearance of pathologies is markedly reduced.
If we consider that diabetes affects the blood vessels, then it seems logical to choose as a method of treating statins. But is it really the right way to treat the disease, can patients choose the metformin or statins tested for years?
Statins and diabetes: compatibility and advantage
As recent studies have shown, statins and type 2 diabetes mellitus may be compatible. Such drugs reduce the incidence of not only the incidence, but also the mortality due to cardiovascular diseases among people with diabetics. The drug Metformin, like statins, has a different effect on the body – it lowers the glucose in the blood.
Most often, a drug under the name of atorvastatin is subjected to scientific research. Also today the drug Rosuvastatin has become very popular. Both these drugs are statins and have a synthetic origin. Scientists have carried out several types of research, including CARDS, PLANET and TNT CHD-DM.
The CARDS study was conducted with the participation of diabetics of the second type of disease, whose low-density lipoprotein indices were not higher than 4.14 mmol / liter. Also among patients it was necessary to select those who did not have pathologies in the field of peripheral, cerebral and coronary arteries.
Each person who participated in the study necessarily had at least one risk factor:
- Increased arterial pressure;
- Diabetic retinopathy;
- Smoking of tobacco products.
Each patient took Atorvastatin 10 mg per day. The control group had to take a placebo.
According to the results of the experiment among people who took statins, the risk of stroke decreased by 50 percent, and the likelihood that myocardial infarction would develop, unstable angina, sudden coronary death, decreased by 35 percent. Since positive results were obtained and obvious advantages were revealed, the studies were stopped two years earlier than planned.
During the PLANET study, the nephroprotective capabilities of Atorvastatin and Rosuvastatin have been studied and compared. The first experiment of PLANET I involved patients who diagnosed the first and second type of diabetes mellitus. Participants in the PLANET II experiment are people who have normal blood glucose levels.
Each of their studied patients differed in high cholesterol and moderate proteinuria – the presence of protein in the urine. All participants were randomly split into two groups. The first group took atorvastatin 80 mg every day, and the second group took 40 mg of rosuvastatin. The studies were conducted for 12 months.
As shown by the scientific experiment, in patients with diabetes, who took atorvastatin, the protein values in the urine decreased by 15 percent.
The group taking the second drug, the reduction in protein levels was 20 percent.
In general, proteinuria has not disappeared from Rosuvastatin. At the same time, the glomerular filtration rate of urine slowed, while the data from Atorvastatin appeared to be practically unchanged.
The study PLANET I revealed in 4 percent of people who had to choose Rosuvastatin, acute renal failure, and also doubling the serum creatinine. Among people. Atorvastatin alone, violations were found in only 1 percent of patients, with no change in serum creatinine levels.
Thus, it was found that the drug Rosuvastatin, in comparison with the analog, does not have protective properties for the kidneys. Including a medicine can be dangerous for people with diabetes mellitus of any type and the presence of proteinuria.
The third study of TNT CHD-DM studied how atorvastatin affects the risk of developing a cardiovascular catastrophe in ischemic disease and type 2 diabetes. Patients were to drink 80 mg per day. The control group took this medication at a dosage of 10 mg per day.
According to the results of the experiment, it was found out that the probability of complications in the cardiovascular system decreased by 25 percent.
What can be dangerous statins
In addition, Japanese scientists conducted several scientific experiments, as a result of which it was possible to obtain very heterogeneous conclusions. At the same time, scientists had to seriously think about whether to take these types of drugs in type 2 diabetes.
This is due to the fact that after taking statins there have been cases of decompensation of diabetes mellitus, this in turn has pushed for a deeper study of medicines.
Japanese scientists have tried to study how atorvastatin acts in the amount of 10 mg per concentration of glycated hemoglobin and blood sugar. Based on the average glucose for the past three months.
The experiment was conducted for three months, 76 patients with a diagnosis of type 2 diabetes mellitus took part in it.
The study demonstrated a sharp increase in the index of carbohydrate metabolism.
In the second study, the drug was administered in the same dosage to people with diabetes mellitus and dyslipidemia.
During a two-month experiment, a decrease in the concentration of atherogenic lipids and a simultaneous increase in glycated hemoglobin were detected.
Also, patients showed an increase in insulin resistance.
After receiving such results, American scientists conducted extensive meta-analysis. Their goal was to find out how statins affect the metabolism of carbohydrates and determine the risk of diabetes during treatment with statins. This included all previous scientific research that relates to the development of type 2 diabetes.
Based on the results of the experiments, it was possible to obtain data that revealed one case of development of type 2 diabetes after 255 therapy with statins among 255 subjects. As a result, scientists suggested that these drugs can affect the carbohydrate metabolism.
In addition, mathematical calculations have established that for every diagnosis of diabetes, 9 cases of preventing a cardiovascular catastrophe occur.
Thus, at the moment it is difficult to judge how useful or, on the contrary, the statins for diabetics are harmful. Meanwhile, doctors firmly believe in a significant improvement in the concentration of blood lipids in patients after the use of drugs. Therefore, if nevertheless to be treated with statins, it is necessary to watch carefully carbohydrate parameters.
It is also important to know which medications are best and to take only a good medication. In particular, it is recommended to select statins that enter the hydrophilic group, that is, they can dissolve in water.
Among them – Rosuvastatin and Pravastatin. According to doctors, these drugs have less impact on the metabolism of carbohydrates. This will increase the effectiveness of therapy and avoid the risk of negative consequences.
For the treatment and prevention of diabetes, it is better to use proven methods. To lower the cholesterol in the blood, you need to adjust the diet, with the development of type 2 diabetes it is recommended to take the drug Metformin 850, which has proven itself, or the Sartans.
About statins is told in the video in this article.