Statin use linked with diabetes, and is heart disease really caused by cholesterol?

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I came across this short video today (below). It mainly concerns some research just out which found that in a huge group of postmenopausal women, statin use was associated with an increased risk of type 2 diabetes [1]. I saw ‘associated’ because this study was ‘epidemilogical’ in nature, meaning that it’s only good for looking at whether things are associated with each other, and can’t tell us if one is causing another. However, as an accompanying editor’s note points out, this finding is also backed by other data from clinical trials that have implicated statins as a potential cause of diabetes.

The video features two doctors from the same centre. One seems more in-tune with conventional thinking than the other. The first tells us that while close to 500 women would need to be treated for one to develop diabetes, in comparison only about 150 would need to be treated to prevent a heart attack or stenting or some other cardiac event. Just let the second figure sink in for a bit. For each 150 women treated, 149 will not benefit in terms of saving them from a cardiac event. The miracles of modern medicine!

But for me the really interesting part of the video came when the second doctor popped up and suggested that cholesterol may not be the issue, but inflammation is a more likely culprit and perhaps it’s that we should be seeking to control (not cholesterol levels). Give that doctor a medal.

References:

1. Culver AL, et al. Statin Use and Risk of Diabetes Mellitus in Postmenopausal Women in the Women’s Health Initiative. Arch Intern Med. 2012;0(2012):20116252-9.

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