Statin Side Effects: Increased Risk For Diabetes

In 2012, 25 years after statins were approved for use, the FDA mandated that manufacturers add a warning to the drug labels about the increased risk of developing diabetes while taking these medications. Statins like Crestor (rosuvastatin), Lipitor (atorvastatin), Zocor (simvastatin), Pravachol (pravastatin), and Mevacor (lovastatin) are commonly prescribed to lower cholesterol and reduce the risk of heart disease. But the more we learn, the more we realize that these drugs, while effective in lowering cholesterol, are not risk-free.

The Diabetes Risk

For years, the risk of diabetes associated with statins was thought to be small. But over time, additional studies have shown that the risk is higher than initially reported. A recent study from Finland, which followed men for six years, found that 11% of those taking statins developed diabetes—a rate 46% higher than those not on statins. This risk was dose-dependent, meaning men who took higher doses of statins had a greater likelihood of developing diabetes. For example, those on a low dose had a 28% increased risk, while those on a higher dose had a 44% increased risk.

Another study involving 9,000 non-diabetic men found that taking statins increased the risk of diabetes by nearly 50% over six years, even after accounting for factors like age, BMI, physical activity, and family history of diabetes.

This data begs the question: Why are we prescribing a drug for high cholesterol, a risk factor for heart disease, that increases the risk of diabetes—another risk factor for heart disease?

Balancing Benefits and Risks

It’s important to note that while the risk of diabetes exists, the absolute proportion of individuals who developed diabetes in these studies was still relatively small. In the study involving 9,000 men, 7% developed diabetes. Not zero, but not overwhelming either.  

Plus, there’s a major caveat around the diabetes risk: it can be difficult to tease out every lifestyle factor at play.  For example, many people who go on statins are sitting ducks for diabetes already:  the reason their cholesterol is high is because they’re eating the wrong foods - the same foods that can fuel elevated blood sugar readings.  And covering up the high cholesterol with a drug will do nothing to improve blood sugar control.  

However, it is fair to say  that statins are not entirely benign and can have real downstream consequences - especially if we don’t address the root causes of high cholesterol and blood sugar abnormalities as part of the therapeutic plan.

It must also be emphasized that individuals with known coronary or vascular disease SHOULD be on statins.  The data is incredibly convincing and consistent that these individuals realize a significant benefit in terms of overall health outcomes (despite the diabetes risk).  But for individuals without known heart disease, jumping to a lifetime of statin therapy should not be taken lightly. In all cases, optimizing lifestyle and diet is imperative - to help reduce the statin doses needed to control cholesterol readings - or even help avoid them altogether in those without established heart disease.

What Should You Do if You Take Statins?

If you’re currently taking statins and are concerned about the diabetes risk, please don’t panic, and certainly don’t stop your medication without consulting your doctor. But also do what  you can to minimize your risk of developing diabetes while managing your cholesterol:

1. Adopt lifestyle changes that lower your personal risk of diabetes. Weight loss, increased physical activity, and improving your diet can help stabilize blood sugar levels.
2. Talk to your doctor about reducing your statin dose. Research shows that lower doses are associated with a lower risk of developing diabetes. By adding two servings of Step One Foods to your daily routine, you may be able to achieve similar or even better cholesterol-lowering effects with a lower statin dose.

The Bottom Line

Statins can be effective, but they are not without risks. By adopting a heart-healthy diet, increasing physical activity, and incorporating solutions like Step One Foods, you can support your cholesterol management without relying solely on medication.

Taking care of your heart should never increase your risk of other serious diseases—and with the right approach, it doesn’t have to.

Read the other blogs in this four part series:

• Statin Side Effects: Muscles Aches
• Statin Side Effects: Cognitive Impairment
• Statin Side Effects: Dangerous Drug Interactions