A couple of weeks ago I posted on the 'statin scare', and referred to a study that discussed the increase risk of diabetes for people taking cholesterol lowering meds in primary prevention.
I was skeptical of a single study as the basis for concern (and certainly panic). Eric Topol's recent videoblog on the issue is underscores the need for careful review of all data, tailoring treatment to patients to maximize benefits and the urgent need for whole genome research on response and metabolism of all statins.I am on a low dose statin. I monitor my liver enzymes pretty regularly (normal for someone who works out as regularly as I claim to!). It never occured to me that the slight elevation in my glucose levels -- something my doctor has always kept an eye on -- was a 'side effect' of statin use. Since we have a family history of high cholesterol and heart attacks statins are indicated and my risk of a heart attack were probably greater if I didn't take statins compared to taking them and getting diabetes. But a more precise and individualized measure of risk and benefit would be greatly appreciated!
Dr. Topol raises important questions about the risks and benefits of using statin in primary prevention absent other risk factors. And he again makes a persuasive case about the value of genomic testing. As he notes in his excellent book The creative destruction of medicine: How the digital revolution will create better healthcare 30 percent of people being treated for diabetes are non-responders to metformin, which is pushed as first line therapy. Why not a test that measures response and reaction to statins and diabetes meds. Why not make that test available to consumers in the most convenient way possible?
The impact on compliance and health outcomes would be significant in my opinion. And as for my use of statins, I will be a bit more careful going forward.
Thanks Dr. Topol.
http://blogs.theheart.org/topolog
