From the Guidelines
Statin medication can cause a modest increase in blood sugar levels, but the cardiovascular benefits generally outweigh this side effect, especially in people with established heart disease or high cardiovascular risk. The increase in blood sugar is typically small, around 5-9 mg/dL on average, and doesn't usually require stopping the medication 1. If you're taking a statin and notice elevated blood sugar, don't stop your medication without consulting your doctor.
Some key points to consider:
- The mechanism behind this effect involves statins slightly impairing insulin sensitivity and pancreatic beta cell function 1.
- People at higher risk for this side effect include those with prediabetes, obesity, advanced age, or using higher-potency statins 1.
- Regular monitoring of blood glucose levels is recommended while on statin therapy, particularly during the first year 1.
- Lifestyle modifications like regular exercise, maintaining a healthy weight, and following a balanced diet can help mitigate potential blood sugar increases while on statin therapy 1.
- The absolute benefits of statin therapy greatly outweigh any excess risks of diabetes associated with the small increase in glycaemia they induce 1.
It's essential to weigh the benefits and risks of statin therapy, considering the individual's baseline risk of cardiovascular disease and diabetes. The decision to initiate or continue statin therapy should be made after discussing the potential benefits and risks with a healthcare provider 1.
From the FDA Drug Label
Increases in HbA1c and fasting serum glucose levels have been reported with statins, including rosuvastatin. Increases in HbA1c and fasting serum glucose levels have been reported with statins, including atorvastatin. Statin medication may increase blood sugar levels, as evidenced by increases in HbA1c and fasting serum glucose.
- This increase may exceed the threshold for the diagnosis of diabetes mellitus 2.
- It is recommended to optimize lifestyle measures, including regular exercise, maintaining a healthy body weight, and making healthy food choices 2 3.
From the Research
Statin Medication and Increase in Blood Sugar
- Statin treatment has been shown to increase the risk of new-onset diabetes, with the risk appearing greatest among the more potent statins 4.
- A dose-response curve has been observed between statin treatment and the development of diabetes, suggesting that higher doses of statins may increase the risk of diabetes 4, 5.
- The mechanisms underlying statin-induced hyperglycemia are thought to include alterations in insulin signaling, glucose transport, and gastrointestinal microbiota 6.
- Statins have been found to affect glucose control by affecting insulin production and secretion, insulin resistance, and insulin uptake by muscles and adipocytes 5.
- The risk of new-onset diabetes associated with statin use is thought to be highest in individuals with obesity or glycemic parameters approximating diabetes thresholds 6.
- Despite the potential risk of increasing blood sugar, the benefit of statin use in preventing cardiovascular disease is still thought to outweigh the risk 7.
- The effects of statins on glycemic control in patients with type 2 diabetes are complex and may involve both favorable and unfavorable effects on glucose metabolism 5, 7.