Which drug is useful for reducing fat

Blood lipid lowering drugs promote diabetes: who needs to be careful?

Status: 07.10.2019 3:07 p.m. | archive
20 percent of people who take cholesterol-lowering drugs suffer from side effects.

Cholesterol-lowering drugs are among the best-selling drugs worldwide. In Germany, drugs from the active ingredient group of statins are mainly used. They lower the level of cholesterol in the blood. This demonstrably reduces the risk of arteriosclerosis, coronary heart disease and strokes. Because increased LDL cholesterol levels are the most important risk factors for these diseases. A common side effect, however, is diabetes because statins increase blood sugar levels.

Statins increase the risk of diabetes

The use of statins can lead to diabetes if they weaken the insulin-producing cells in the pancreas. Then less insulin arrives in the muscle cells, the blood sugar level rises and the body stores the unused sugar as a fat reserve. This promotes the development of diabetes.

A recent study from the Netherlands of people between the ages of 55 and 75 showed that those who took statins were 38 percent more likely to have diabetes.

This means that if a person's risk of developing diabetes in the next ten years is five percent, taking statins increases it to around 6.5 to 7 percent. At the same time, the drugs reduce the risk of a heart attack or stroke.

Weigh the risk of blood lipid lowering drugs individually

Whether a therapy with statins makes sense despite the possible side effects depends on the individual risk profile of the patient:

  • Are there any previous illnesses in the family, signs of arteriosclerosis or other risk factors such as high blood pressure?
  • Even those who have already suffered a heart attack or stroke usually need statins for prevention.

As a rule, the effectiveness of statins is more important than the risk of diabetes, which can be limited through exercise and a healthy diet. However, it is important to have your blood sugar level checked regularly.

Statins can cause other side effects

The body cannot break down the waste products of the statin. Normally, so-called carriers take the statin waste and transport it away. However, for some people, carriers refuse to take certain statins. You don't let the waste product dock. This can be genetic or caused by other medications, grapefruit juice, or St. John's wort. The waste products then lead to a kind of poisoning in the body, which can lead to various side effects, for example muscle pain.

Coenzyme Q10 for muscle pain

Physically active people in particular suffer more frequently from muscle pain (statin myopathy) when they take statins. The statins disrupt the energy supply to the muscle cells. The important coenzyme Q10 is reduced. As a result, the muscles do not receive the necessary energy. The enzyme is then also broken down during exercise and the associated muscle work.

In smaller studies, doctors have made the experience for years that the additional intake of the coenzyme Q10 can help against muscle pain without having to change the statin. The substance Q10 is available as a food supplement without a prescription. However, there has not yet been a large scientific study that proves the effectiveness of Q10. It should always be taken in consultation with the attending physician.

Since the Q10 level is already reduced with increasing age and all statins additionally reduce the Q10 content in the muscles, the intake of the coenzyme Q10 is recommended with any statin intake - even without muscle pain. It also shortens the recovery time after muscle loads (sport), which are essential for people with lipid metabolism disorders.

It is also important to support the effect of statins with sufficient vitamin D. For many people, vitamin D is reduced in months with little sun and should be substituted, especially if it is proven to be deficient.

Statins: Questions and Answers

What else is important when taking statins?
St. John's wort and grapefruit juice displace statins on the excretory carriers. Statins are then no longer excreted and their levels rise critically. Therefore: Never take St. John's wort or grapefruit together with statins (or many other effective drugs).

When are statins useful in old age?
If it is proven that you have not developed vascular arteriosclerosis by the age of 80, the likelihood of developing another is very small. In these patients there is probably no need to start prophylactic statin therapy. In the case of correspondingly pre-stressed patients, however, there is clearly an urgent need to continue statin therapy even in old age. When giving statins for prophylactic reasons (genetic risk, family history, proven changes in the neck or leg vessels, poor cholesterol distribution: HDL <45 and LDL> 150), statin therapy is not just statin therapy: Due to the pharmacokinetics, a low statin dose in the Usually at least 70 percent of the possible effect, i.e. with high doses you only achieve another 30 percent effect, but with the disadvantage of correspondingly more side effects with a higher substrate dose.

Can I take PCSK9 inhibitors if I have statin intolerance?
Current status: PCSK9 inhibitors only if the targets are not achieved despite maximum therapy with statins and ezetimibe.

Recognize and remedy vitamin D deficiency

At least 30 percent of Germans have too little vitamin D in their blood during the winter months. Those who live in northern Germany have an even higher risk due to the lower solar radiation. more

Experts on the subject

Dr. Matthias Riedl, internist, diabetologist, nutritionist
medicum Hamburg MVZ GmbH
At the straw house 2
20097 Hamburg
(040) 80 79 79-0
www.medicum-hamburg.de

Dr. Stephan Brune
Cardiology Stade
Harsefelder Strasse 6
21680 Stade
www.kardiologiestade.de

Prof. Dr. Jens Aberle, medical director
UKE GmbH ambulance center, department of endocrinology, diabetology, obesity and lipids
Martinistrasse 52
20246 Hamburg
(040) 74 10-500 85
www.uke.de

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