If all doctors followed the latest cholesterol treatment guidelines and all their patients took their prescribed statin medication, there would be 3.5 million more diabetics in America. But wait! There is another pill (or injection, actually) that has been shown to reduce the risk of diabetes. And it’s only about $50,000 per year per patient. Let’s see: 3.5 million, times $50,000. What does that bring us to?
We are stuck in an absurd cultural habit of thinking that medication will save us from lifestyle and social diseases.
Two separate studies in the June 21st 2011 issue of the Journal of the American Medical Association (JAMA) underscore that we have come to the end of an era of being saved by medication. Antibiotics and vaccines were a huge advance in medicine in the 20th century. But the single pill for the single ill just doesn’t work for 21st century chronic diseases like heart disease and diabetes.
Statins cause diabetes
The latest cholesterol guidelines (ATP III) increased the number of Americans who should take statin therapy from 13 to 40 million. Those additional 27 million are ones without heart disease, but who have high cholesterol. This type of treatment is called primary prevention. I have extensively reviewed the research on using statins to prevent heart attacks in people who never had them. The data is weak and shows no benefit, except the Jupiter trial, which ONLY showed benefit if patients also had inflammation (high C-reactive protein), not just high cholesterol or LDL. If you just had an elevated cholesterol, statins didn’t help.
I have previously written about research that showed that statins increase the risk of diabetes. This latest study examined five major clinical trials on statins that included 32,752 non-diabetics over 4.9 years. During the study period, 2,749 patients (or 8.4 percent) developed diabetes. Those on the highest doses of statins (which are increasingly prescribed by physicians) were at the highest risk of developing diabetes.
While there was a slight overall reduction in risk of heart attacks in the patients treated with statins, the authors found that you have to treat 155 people for one year to prevent just one heart attack or death. If a doctor had to prescribe antibiotics to 155 people to cure just one patient of pneumonia, we would think that antibiotics weren’t very good medication. But that is exactly the “number needed to treat” to prevent just one cardiac event. On top of that, for every 498 people treated, one more person would become diabetic. If these drugs were not the top-selling drugs in history, we might accept a small risk, but if we treated everyone who “needed” them, we would have more than 3.5 million more diabetics in America.