Statins can cause abnormal blood sugar levels, so can people with diabetes take statins?

A friend told Huazi that he had diabetes and his doctor recommended that he take statins to prevent cardiovascular and cerebrovascular complications. However, he saw an article saying that statins can cause abnormal blood sugar levels and worsen blood sugar control in diabetic patients, so he was hesitant and asked Huazi if people with diabetes can take statins.

Huazi's answer to him was to follow the doctor's advice and take statins. For people with diabetes, the benefits of taking statins in protecting the cardiovascular system far outweigh the risks of abnormal blood sugar levels.

1. Statins have a protective effect on cardiovascular and cerebrovascular diseases. Many clinical trials have confirmed that statins have an important protective effect on cardiovascular and cerebrovascular diseases. Statins play a protective role mainly in two ways: one is to regulate blood lipids and reduce the level of low-density lipoprotein cholesterol (LDL-C); the other is to improve the metabolism of the arterial lining, fight against the oxidative reaction and inflammatory stress reaction caused by LDL-C, strengthen atherosclerotic plaques, and make the plaques stable and not easy to rupture.

Although other lipid-lowering drugs can also regulate blood lipids and reduce LDL-C, they lack the effect of improving the arterial intima and stabilizing plaques. Therefore, there is currently no other drug that can completely replace the protective effect of statins on cardiovascular and cerebrovascular diseases. As long as there are no serious adverse reactions, people at high risk of cardiovascular and cerebrovascular diseases need to take statins for a long time.

2. Diabetic patients should pay attention to the protection of cardiovascular and cerebrovascular diseases. Diabetes is a metabolic disease characterized by high blood sugar, which is caused by the disorder of pancreatic islet function. Insulin has important regulatory functions on sugar and fat, so in most diabetic patients, abnormal blood sugar is accompanied by abnormal blood lipids.

In the treatment of diabetes, there is a treatment theory that "almost all diabetic patients need to add statins." This is because the macrovascular complications caused by diabetes are the main cause of disability and death in diabetic patients. About 70% of diabetic patients will eventually die from macrovascular disease.

The mechanism that causes this disease is that high blood sugar and high blood lipids can cause damage to the arterial intima, and LDL-C will enter the arterial intima from the damaged area, forming atherosclerotic plaques, which will eventually cause arterial occlusion and cause the disease.

Statins can lower the level of LDL-C, which can help to "eliminate the problem" of atherosclerosis. When the LDL-C in the blood is reduced to 2.0mmol/L, LDL-C will not enter the arterial intima; when the LDL-C in the blood is reduced to 1.8mmol/L, the LDL-C in the arterial intima will flow back into the blood. Therefore, lowering the level of LDL-C is of great significance in delaying the progression of atherosclerosis.

3. Correctly view the impact of statins on blood sugar. When using statins, patients may experience abnormal blood sugar, which is manifested as increased fasting blood sugar, new-onset diabetes, and worsening blood sugar control in diabetes. Statins cause abnormal blood sugar, mainly when used in high doses. Due to genetic differences, Europeans and Americans need to use larger doses of statins to be effective, while Chinese are more sensitive to statins and usually use medium to low doses to achieve the desired effect.

Therefore, for Chinese people who usually use low- to medium-dose statins, the probability of abnormal blood sugar is not high. Moreover, among statins, there are low-intensity statins that have a weaker effect on blood sugar, but their ability to regulate blood lipids is also weaker. People with low levels of elevated blood lipids can choose low-intensity statins under the guidance of a doctor.

However, for people with high blood lipid levels, statins need to be used from the perspective of protecting the cardiovascular system. After all, we have many drugs to regulate blood sugar. When blood sugar changes, we just need to adjust the hypoglycemic drugs to control it. As for the protection of the cardiovascular system, there is no other drug that can completely replace statins.

If the risk of statins causing abnormal blood sugar is considered as "1", then its protective effect on cardiovascular and cerebrovascular diseases is "9". The protective effect of statins far outweighs the risk of affecting blood sugar, so diabetic patients should insist on taking statins, but during the course of taking statins, they should closely monitor blood sugar and adjust the hypoglycemic drugs according to blood sugar changes.

In summary, diabetic patients need to pay attention to the protection of cardiovascular and cerebrovascular diseases and can take statins. During the medication process, pay attention to monitoring blood sugar levels and adjust hypoglycemic drugs to counteract the abnormal blood sugar levels that may be caused by statins. As a reminder, the use and adjustment of statins and hypoglycemic drugs need to be carried out under the guidance of a doctor. If you find any problems during medication, please consult a doctor or pharmacist in time. I am pharmacist Huazi, welcome to follow me and let me be the pharmacist by your side.