This just sounds like your opinion? There’s clear evidence that statins increase risk of developing diabetes.
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Beth, same here, very nice app BUT they also sell products and I’m sure they are high quality. I also noted the medicore ratings for my main sources NOW and BulkSupplements. But my essential items, like fish oil and astazanthin, I buy a common brand and a high priced brand for insurance. None of my high priced brands were listed. Why would they “advertise” or even acknowledge a direct competitor? They’re trying to make a buck, which is not odd at all. I still am using them, I scanned my supplements then imported that into a ChatGPT AI and that AI is where I manage my list. But for a quick barcode id/info on common brands, they’re tops.
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I thought you were a guidelines person. They note the small diabetes risk but state that “the benefits of reducing ASCVD events greatly outweigh the risks.”
The Scientific Statement from the American Heart Association presents evidence for a minimal risk (0.2% per year) of developing newly diagnosed diabetes mellitus on statin therapy, which is predominately among patients with pre-existing risk factors for developing diabetes (e.g. adults with pre-diabetes/metabolic syndrome). The mechanisms of the diabetogenic effect of statins remain unclear. The JUPITER Trial13,19 was the first prospective study evaluating statins and newly diagnosed diabetes mellitus among 17,802 patients without known diabetes at the beginning of the study. In the rosuvastatin group 0.6% more patients were reported to have diabetes by their physician over a median of 1.9 years with a small but statistically significant HbA1c difference of median values of 5.9% for rosuvastatin vs. 5.8% for placebo, with no significant difference in fasting glucose.
A large meta-analysis with pooled data of 32,572 patients showed over a median of 4.9 years on statin therapy that 2 cases of diabetes occurred per 1000 patient-years of treatment and 6.5 cardiovascular events (stroke, myocardial infarction, revascularization) per 1000 patient-years were prevented20. Additionally, patients with diabetes on statin-therapy have a negligible increase in HbA1c as shown in AFORRD21 (atorvastatin 20mg vs. placebo; N = 800) and CARDS (atorvastatin 10mg daily vs. placebo N = 2,838) 22,23 RCTs with increases in HbA1c of 0.3% and 0.1% respectively at 4 years.
The Scientific Statement from the American Heart Association raises the question if statin therapy accelerates the development of diabetes in those patients with metabolic syndrome, who would otherwise likely develop it. Among patients on high-intensity statin with risk factors for diabetes, it is prudent to continue aggressive prevention with lifestyle modification (weight loss if indicated and better exercise habits) and periodic screening for diabetes.
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You’re talking oranges when I’m talking apples.
I was talking about people on this forum who take statins to lower cholesterol when they already have normal cholesterol levels. There are no guidelines for this. Is the benefit of the this worth the risk of worsening insulin sensitivity?
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Not all statins cause that side effect and there is a clear threshold where soft plaque actively starts to regress.
I understand from your posts that you do not like statins. So be it; you’re welcome to your opinion, but it goes against the preponderance of medical opinion.
Every medication that I take has some adverse consequences for some people. We must always weigh the benefits vs. the negative risks.
“Cardiovascular protection conferred by statins vastly offsets the modest diabetes risk.”
Anyone is welcome to read the papers I have linked and draw their own conclusions.
This is only a small portion of the references I have about statins and diabetes.
The references are from Claude, ChatGPT, and Gemini.
“The best evidence comes from large randomized trials and meta-analyses. The key point is that statins do appear to increase the risk of new-onset diabetes slightly, but the absolute risk is small, and varies by dose and type.”
The Net Benefit Framing
The consensus across recent reviews is that the cardiovascular protection conferred by statins vastly offsets the modest diabetes risk, and this risk should not deter initiation of guideline-recommended therapy. PubMed Central The 2024 CTT analysis specifically notes that any theoretical adverse cardiovascular effects arising from the small glycemia increases are already accounted for within the overall cardiovascular risk reduction seen in the trials. PubMed
A 2024 Cholesterol Treatment Trialists’ (CTT) Collaboration meta-analysis in The Lancet Diabetes & Endocrinology confirms that while statins slightly increase the risk of new-onset diabetes—by 10% for low-intensity and 36% for high-intensity—the cardiovascular benefits significantly outweigh this risk. The risk is highest for individuals with pre-existing high blood sugar, as statins may cause a small increase in HbA1c that triggers an earlier diagnosis, particularly at higher doses. Read the full study in The Lancet
Overall Risk Magnitude
The evidence is consistent but the magnitude depends heavily on study design. RCT-based meta-analyses tend to show more modest effects than observational studies, which capture longer exposures and real-world populations:
Bottom line: Absolute risk of statin-attributable diabetes in a metabolically healthy person is quite small. The risk is real but concentrated in those already near the diabetic threshold, escalates with dose intensity, and varies meaningfully by agent — with rosuvastatin and high-dose atorvastatin at the higher end, and pravastatin and pitavastatin at the lower end.
Bottom line (causal estimate)
- Best estimate (RCT-based):
- ~9–12% relative increase
- ~0.1–0.3% per year absolute excess risk
- Roughly 1 additional diabetes case per 200–300 users over ~4 years
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I take pitavastatin 2mg so I guess based on below I need not worry about the risk of insulin resistance: am I right @KarlT or I may be missing something?
Pitavastatin may have beneficial effects on insulin sensitivity, particularly in patients with type 2 diabetes, although some studies indicate it may not significantly impact insulin resistance overall.
Effects on Insulin Sensitivity
4 Sources
Conclusion
Overall, pitavastatin may offer some benefits for insulin sensitivity, particularly in individuals with type 2 diabetes, but its effects are not universally significant across all studies. Patients considering pitavastatin for cholesterol management should discuss potential impacts on insulin resistance with their healthcare provider, especially if they have concerns about diabetes or metabolic health. Further research is warranted to fully understand the implications of pitavastatin on insulin sensitivity and glucose metabolism.
I think your preventative approach makes some sense. I am curious why you take modafinil, and how often and in what dosages?
This I took as an experiment for mood uplifting and motivation (I’m not aware of any preventative or longevity benefits) and it is a very powerful substance. I took 50mg and yes, it makes a difference in mood and motivation though I did experience a couple side effects such as It increased my appetite drastically basically, I was hungry no matter how much I ate, plus there was a significant late afternoon crush (I took the dose in the morning). so, I’m not going to take it very often, only on rare occasion I might need a boost at work or at a certain social setting.
I am using Selegiline though regularly which had very similar uplifting mood effect as modafinil and helps me with inflammation, but I have witnessed no side effects. so, I’ve been taking Selegiline for 10 days now and intend to use it perhaps forever…I only take 1.25mg in the morning under my tongue but might up the dose to 2.5 in the future. btw, just placed an order for 600 selegiline 5mg tablets and that should last me 4-6 years depending on dose I settle on. .
Switch to Pitavastatin which does not affect insulin sensitivity but still lowers cholesterol like the other statins. This is what I do. You simply have to pay more or buy it from India or Shenzhen. Fortunately, the manufacturing plant for Pitavastatin is an hour drive north of where I live and the pharmacies around there sell it Indian cheap.
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You are mistaken. I have never said I didn’t like statins. Statins are an important drug class of great value. My point is what you said “every medication…has adversely consequences”. Many people do not consider that. Those adverse effects weigh heavier if the benefits are negligible.
My argument is not against the use of statins. It’s against using statins if they’re not adding a benefit.
Many people in the forum take statins because “normal” isn’t good enough.
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Thats an interesting question. I dont take statins. Setting up a poll may have merit.
Thanks for your response. I have used modafinil from time to time when I really need to focus on a project and get it done or at least make substantial progress. Contrary to your experience, it reduces my appetite, proving once again that individuals often react differently to a substance. I take it in the morning and start to feel great and focused about 40 minutes later. I stay in that zone for several hours, and then start to come down. The one drawback for me is the crash that comes later. Feel jittery and no longer able to work with much concentration; tired but takes longer than usual to get to sleep.
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Other than the appetite which seems we have opposite effects the rest is exactly the same. I wonder what the dose was you felt best? The highest I’ve used is 50mg and would like to increase it but I’m afraid I might start levitating and not being able to touch the ground again LOL
What does that mean? What is good enough?
I’d say good enough is less than 70 and ideally 50- 60. Mine was 124 last time I checked thus I’m taking Pita 1-2mg and Ezetimibe 5-10mg.
You have been a forum member for quite some time. You must have noticed in various threads that we have rehashed LDL-C and statin pros and cons and dosages ad nauseam. The lines were drawn on both sides, from Dr. Lipid suggesting as low as possible to Kausik K. Ray, MD et al.'s “literature-based meta-analysis did not find evidence for the benefit of statin therapy on all-cause mortality in a high-risk primary prevention setup.”
You can have the last word. I am putting this year’s long forum debate to rest as far as I am concerned.
I am following the theory that the LDL-C sweet spot is between >30 mg/dL and <70 mg/dL. And if you need statins to reach this level, that is for you to decide.
“LDL-C levels <70 mg/dL (<1.8 mmol/L) were linked to a 26% decreased risk of all-cause dementia and a 28% decreased risk of ADRD, compared with having LDL-C levels ≥130 mg/dL (≥3.4 mmol/L) in cohorts matched at 1:1 ratio”
"However, LDL-C levels <30 mg/dL (<0.8 mmol/L) did not exhibit reduced dementia risk compared with the LDL-C ≥130 mg/dL (≥3.4 mmol/L) group.
Our findings support the notion of an inverted J-shaped relationship, as we observed that LDL-C levels below 30 mg/dL (0.8 mmol/L) did not show a reduced risk of dementia compared with levels >130 mg/dL (>3.4 mmol/L), contrary to what is typically observed with LDL-C levels <55 mg/dL (<1.4 mmol/L) or 70 mg/dL (1.8 mmol/L). This finding suggests that LDL-C levels <30 mg/dL (<0.8 mmol/L) do not significantly increase dementia risk."
Very Low LDL Levels Slash Dementia Risk - Statins Helpful
Video “How I Use Statins to Unclog Arteries” ~ Dr. Ford Brewer, MD. One thought is to use statins to prevent clogged arteries in the first place.
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The idea is that lipoproteins like Lp(a)-apoB, TRL-apoB, and LDL-apoB are causal factors for atherosclerosis and increases risk of ASCVD.
Further they are causal in a cumulative way, where decreasing levels earlier has a larger effect than later.
Normal levels can be anything from the 5th to the 95th percentile of these lipoproteins, depending on your age, the latter is actually just a measure of how much you’ve already accumulated from lipids or other related risks.
Normal is definitely not good enough – when genetic studies demonstrate the effects from decreasing from the normal, we’re talking about a reduction in lifetime CHD events. Your target depends on your overall risk profile, usually below 20th-5th percentile.
You don’t really need a big dose of LLT to get to the target if diet is low in SFA and high in PUFA at the same time.
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Sounds like a good idea. The risk of diabetes with pitavastatin is not zero but it’s relatively lower than other statins and it is somewhat low as far as muscle side effects.
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