- The Washington Times - Monday, June 7, 2004

Nearly all diabetics should take a statin drug to lower cholesterol, even if they already have low cholesterol levels, the American Diabetes Association is advising in new treatment guidelines.

“It is now a consensus that having diabetes is the equivalent in terms of cardiovascular risk of already having had a heart attack. … It may well be that everybody with diabetes should be on a statin,” said Dr. Nathaniel Clark, the ADA’s national vice president of clinical affairs.

A landmark study in Britain and Ireland of nearly 3,000 people who had the most common form of diabetes found that a low dose (10 milligram) of the statin drug Lipitor sharply reduced the risk of serious heart disease and strokes even in people with normal cholesterol.

The study found that Lipitor cut the risk of serious heart problems by 36 percent and of stroke by 48 percent. The results were presented at a weekend meeting of the ADA in Orlando, Fla.

Doctors usually don’t prescribe cholesterol-lowering medications until a patient’s total cholesterol reading reaches 200. But Dr. Clark called diabetics a special case, because they are a “high-risk group” for heart attack and stroke.

The recognized value of statins in reducing the risk of cardiovascular disease comes as a study finds that nearly half of patients who have a prescription for the drugs fail to fill it regularly or stop taking the medications.

Such negligence was especially common among those whose insurance co-pay for a month’s supply of a statin drug was more than $20, according to the study in the Journal of General Internal Medicine this month.

Especially startling was that low adherence rates were nearly the same for patients who had high cholesterol and for those who were on statins because they had had a heart attack, been diagnosed with diabetes or clogged arteries, or had had surgery or angioplasty to open blocked arteries.

Researchers from the University of Michigan Health System and the Cleveland Clinic said they had wrongly assumed that sicker patients would be more compliant.

The ADA’s recommendation that all diabetics take statins comes as new research suggests that these drugs also may be beneficial for cancer prevention.

Two studies, released Sunday at a national cancer conference in New Orleans, found that people who took statins sharply reduced their risk of developing colon cancer and prostate cancer.

A study by University of Michigan researchers found that Israelis who took statins for at least five years cut their risk of colorectal cancer in half. A study at the Oregon Health and Science University Cancer Institute found that men who took statins for any length of time had a 58 percent lower risk of prostate cancer.

Previous studies have linked statins to reductions in breast, prostate and across-the-board cancer risks. However, scientists involved in the latest research said it is still too early to conclude that statins can prevent cancer.

But what is well-known is that statins reduce the amount of cholesterol the body produces, which means that they help block cardiovascular disorders. They do that by interfering with an enzyme that enables the liver to manufacture cholesterol.

Popular statin drugs on the market today include Pfizer Inc.’s Lipitor; Bristol-Myers Squibb Co.’s Pravachol, and Merck Co. Inc.’s Zocor.

Heart disease has long been the United States’ leading medical killer and diabetics have at least five times the risk of incurring cardiovascular disease from clogged arteries than nondiabetics.

This article is based in part on wire service reports.

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