Statins and Diabetes: What You Should Know

Heart disease is one of the most common complications of diabetes. Taking medicine to lower your cholesterol levels can be key to preventing heart disease and stroke.

Lifestyle changes such as eating healthy and being active are an important part of managing diabetes. But your doctor may also prescribe a combination of medicines to help you manage your diabetes and reduce the risk of complications. Because heart disease is one of the most common complications of diabetes, taking statins to lower your cholesterol levels can be key to preventing heart disease and stroke.

Heart disease is the leading cause of death for people in the United States, especially among White, Black, and Native Hawaiian or Other Pacific Islander people. While heart disease and stroke can affect anyone, people with certain health conditions, like diabetes, are at higher risk. People with diabetes are twice as likely to have heart disease or a stroke compared to people without diabetes. And the longer you have diabetes, the more likely you are to have heart disease. This is because over time, high blood sugar can damage the blood vessels and nerves that control your heart.

A common cause of heart disease for people with diabetes is plaque (cholesterol deposits) that builds up in the arteries. When plaque continues to build, your arteries narrow, making it harder for blood to flow to your heart. This can cause heart muscles to weaken, which can increase the risk of heart attack and stroke. For this reason, your doctor may prescribe a statin (blood cholesterol-lowering medicine) to reduce your risk of heart disease.

About half of people who are taking medicine to manage their high blood cholesterol are using a statin. While statin use is highly recommended to lower the risk of heart disease, research shows that younger adults, women, and people without insurance are less likely to receive a statin prescription. Compared with non-Hispanic White people, non-Hispanic Black and Hispanic people have lower rates of cholesterol management. Further, women and Black adults are less likely to use statins. It’s important to know your risk for heart disease and stroke and to talk to your health care professional about all possible treatment plans.

What Are Statins?

Statins are a type of cholesterol-lowering medicine that reduces the amount of cholesterol made in the liver. Statins also help remove LDL (“bad”) cholesterol that’s already in the blood and raise your HDL (“good”) cholesterol. They can also:

• Reduce the buildup of plaque on the walls of your arteries.
• Stabilize plaque so that it doesn’t break off and block blood flow to the heart or brain.
• Decrease swelling in the walls of your arteries.
• Decrease the chance of blood clots forming.

There are several types of statins, each with different dosage levels and intensity (strength). A statin prescription will be based on your individual factors. These include your blood cholesterol levels, your risk for heart disease, and your tolerance of a specific statin. Your health care team will work with you to determine the best type and dosage to reduce your risk of heart disease and manage your diabetes.

Can Statins Increase Blood Sugar?

Some research has found that using statins increases blood sugar because statin use can stop your body’s insulin from doing its job properly. This can put people who use statins at higher risk of developing type 2 diabetes.

Despite the risk, statin use is still recommended for many people with and without diabetes who have high blood cholesterol. This is because even though there are risks with taking this medicine, there are greater potential risks if you don’t take them, like having a heart attack or stroke. Remember everyone is different. It’s always best to talk to your doctor about your individual risks and benefits of taking statins.

What Else Can I Do to Protect My Heart?

Having healthy cholesterol and blood sugar levels are important to reduce your risk of heart disease.

Although statins help reduce your risk of heart disease, healthy lifestyle habits are an important part of reducing your risk. Lifestyle changes you can make to reduce your risk include:

• Eating healthy. Include more whole grains, fruits and non-starchy vegetables, and lean protein in each meal. Also try to avoid foods high in added sugars, saturated fat, and sodium (salt).
• Maintaining a healthy weight. Too much belly fat can increase your risk for type 2 diabetes, heart disease, and stroke. If your body mass index (BMI) falls within the overweight or obesity range, losing even just a few pounds can lower your cholesterol and blood sugar levels.
• Being active. One of the best ways to manage diabetes is to get regular physical activity. Little changes like taking the stairs instead of the elevator are good ways to get your body moving.
• Managing your blood sugar. High blood sugar damages blood vessels and nerves throughout different parts of your body, including your heart. Keeping your blood sugar in your target range is key for managing diabetes and preventing serious complications.
• Managing your blood pressure. High blood pressure can damage your arteries by making them less elastic. This can decrease the flow of blood and oxygen to your heart and leads to heart disease. A normal blood pressure is below 120/80 mm Hg  (or the target your health care professional sets).

• Limiting or avoiding alcohol. The Dietary Guidelines for Americans recommends that adults of legal drinking age choose not to drink, or drink in moderation. This means two drinks or less a day for men or one drink or less a day for women. Drinking at levels above the moderate drinking guidelines increases the risk of health problems, like high blood pressure and some types of cancer.
• Quitting smoking if you smoke. Smoking greatly increases your risk for heart disease. If you smoke, there are several programs and resources to help you quit. If you don’t smoke, don’t start.

Talk to Your Doctor

Be sure to talk to your doctor if you have any questions or concerns about your diabetes management and treatment plan. And don’t forget, you can work with a diabetes care and education specialist to help avoid health complications such as heart disease. Your care team is there to help you prevent or treat any health problems caused by diabetes.