If I develop abnormal blood sugar levels while taking statins, can I continue taking them?

A friend told Huazi that his blood sugar level was abnormal when he was taking atorvastatin. What should he do next? Can he continue taking it? Can he switch to other lipid-lowering drugs? Huazi said that he was advised to continue taking it because the benefits of taking statins outweigh the adverse reactions of affecting blood sugar.

You can also switch to other statins under the guidance of a doctor, but it is not recommended to stop taking statins because no other drug can replace the effect of statins in the treatment of atherosclerosis.

1. Statins affect blood sugar. When used, statins will affect blood sugar and increase the probability of new diabetes, but the impact is not significant. In a large data analysis, the incidence of diabetes in people who took statins for a long time was 4.89%; in people who did not take statins, the incidence of diabetes was 4.5%.

In other words, taking statins will only increase the probability of new-onset diabetes by 0.39%. The specific mechanism of the effect is not yet clear, but it may be that statins prevent the conversion of glucose to cholesterol, causing blood sugar to rise; it may also affect the use of glucose by muscle cells, leading to insulin resistance.

But in general, the probability of taking statins affecting blood sugar is not high, so we cannot throw the baby out with the bathwater.

2. The role of statins is irreplaceable The main role of statins is to reduce the level of cholesterol in the human body, especially to significantly reduce the level of low-density lipoprotein cholesterol (LDL-C). LDL-C is the main raw material of atherosclerotic plaques. As long as it is reduced to a low enough level (below 1.8mmol/L), the progression of atherosclerotic plaques can be prevented.

In addition to lowering LDL-C levels, statins also have anti-inflammatory and antioxidant effects, and can improve the metabolic function of the arterial endothelium. Long-term use (usually more than 2 to 4 years) can increase the density of the lipid core of the plaque and reduce its volume, thereby playing a "plaque reversal" role.

The danger of atherosclerotic plaques lies mainly in their instability, which makes them prone to rupture, induce platelet aggregation, and form thrombi. This is the main pathogenesis of cerebral infarction and myocardial infarction. Statins can increase the stability of plaques and make them less likely to rupture.

Although we now have a variety of lipid-regulating drugs such as niacin, fibrates, antioxidants, cholesterol absorption inhibitors, PCSK9 inhibitors, etc., only statins can significantly reverse plaques and increase plaque stability. Other lipid-lowering drugs can be used in combination with statins to control blood lipids, but they cannot completely replace the effects of statins.

3. What to do if blood sugar is abnormal? For people with atherosclerosis, the therapeutic effect of statins is very important. Even if blood sugar is abnormal, it is not recommended to stop taking the medicine. If blood sugar is slightly elevated, blood sugar can be controlled by controlling diet, increasing exercise, and maintaining a standard weight.

You can also choose other statins under the guidance of a doctor, because everyone has different sensitivities to different statins. Among statins, pitavastatin has the smallest effect on blood sugar, and pravastatin also has a smaller effect on blood sugar. However, their lipid-lowering strength is weak, and they may need to be combined with other lipid-lowering drugs to effectively control LDL-C.

If the patient's condition is not suitable for changing medication, hypoglycemic drugs can be added according to blood sugar conditions instead of stopping statins.

In summary, statins may cause blood sugar to rise, but the probability is very low, so people who take statins should not worry too much. Moreover, there is no other drug that can replace the preventive effect of statins on myocardial infarction and cerebral infarction. Even if blood sugar abnormalities occur, it is not recommended to stop taking the drug. You can switch to other statins, or use them in combination with hypoglycemic drugs, and persist in treatment.

Drugs must be used under the guidance of a doctor. If you have any questions about medication, please consult a doctor or pharmacist. I am pharmacist Huazi, welcome to follow me and share more health knowledge.