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Link Between Statins and Blood Sugar

Statins can increase blood sugar levels. But some statins have less effect than others. Find out which one(s).

Can statins increase blood sugar?

The short answer is yes. All statins have a warning & precaution of an increase in

  • HbA1c (average blood sugar levels over the past three months) and
  • fasting serum glucose levels (blood sugar levels after an overnight fast)

This can affect both people who already have diabetes, or those who do not. That being said, not all statins are the same. And some statins may have less of an effect than others on blood sugar levels.

Study suggests Zypitamag (pitavastatin) may have less of an effect on blood sugar levels

A randomized controlled trial looked at the effect of atorvastatin vs. pitavastatin in lowering cholesterol in people who have high cholesterol and type 2 diabetes.

Statins and blood sugar levels

Cholesterol lowering effects

4mg pitavastatin lowers cholesterol similarly to 20mg atorvastatin

Pitavastatin demonstrated effective LDL-cholesterol lowering of up to 41% with 4 mg pitavastatin compared to 20 mg Lipitor® (atorvastatin) which showed a 43% decrease in LDL cholesterol.1

Effects on blood sugar levels

Pitavastatin had minimal effect on glucose

Pitavastatin had a non-significant change in fasting serum glucose levels compared to baseline, whereas atorvastatin 20 mg had a significant increase.1

* P<0.05 vs baseline

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Why do statins increase blood sugar levels?

Statins lower cholesterol levels by blocking a liver enzyme called HMG CoA reductase which is essential for cholesterol production.

Some laboratory and animal studies have suggested that statins may also impact a pathway called the mevalonate pathway, which could potentially affect the function of β-cells in the pancreas. These cells are responsible for releasing insulin, and statins might lead to decreased insulin sensitivity.

Initially, it was believed that all statins had this effect, but recent findings suggest that certain statins, like pravastatin and pitavastatin, may have neutral effects on blood sugar levels in patients with and without diabetes.

Although there is a slight increase in the risk of elevated blood sugar levels with statin therapy, the benefits of statins in preventing heart disease far outweigh this potential risk.

How statins affect blood glucose in people with type 2 diabetes

If you have type 2 diabetes and are taking a statin, it is important to monitor your hemoglobin A1c (HbA1c) and blood glucose levels. Statins can potentially increase these numbers.

Not all statins are the same

A study conducted in 2018 looked at 23 clinical trials to see how different statins affected HbA1c and fasting blood sugar in type 2 diabetes patients. The results showed that a particular statin called "moderate-intensity pitavastatin" was linked to lower HbA1c and fasting blood sugar levels compared to other statins like atorvastatin and rosuvastatin.

If you have type 2 diabetes and your cholesterol level is above 70mg/dL, the recent Blood Cholesterol guidelines recommend starting you on a moderate or high-intensity statin between the ages of 40 and 75. This is because diabetes increases your risk of heart disease, and taking statins can help reduce that risk.

If you have type 2 diabetes, pitavastatin might be a suitable option for you based on the study's findings.

How statins affect blood sugar in people without diabetes

Statins can increase blood glucose and HbA1c levels in individuals who do not have diabetes. However, there is less research on this topic compared to how statins affect those with diabetes.

In a recent study conducted in 2023, researchers analyzed data from 67 studies to understand the impact of statin therapy on HbA1c and insulin resistance (measured using HOMA-IR) in people without diabetes. They categorized participants into groups based on their normal or elevated HbA1c and HOMA-IR levels.

  • HbA1c: an average blood sugar levels over the past three months
  • HOMA-IR: a mathematical index used to estimate insulin resistance in the body.
    A higher number = greater insulin resistance (the body is having more difficulty using insulin effectively)
    A lower number = better insulin sensitivity (the body responds well to insulin)

Here's what the study found for people without diabetes:

Effect of statins on those with normal HbA1c

For individuals with a normal HbA1c level (less than 6.5%), rosuvastatin and atorvastatin led to a significant increase in HbA1c levels. However, other statins like simvastatin, pravastatin, and pitavastatin did not show a significant increase in HbA1c.

Effect of statins on those with normal HOMA-IR

Among people with normal insulin actions (normal HOMA-IR), rosuvastatin, simvastatin, and atorvastatin caused a significant increase in the HOMA-IR index, indicating increased insulin resistance. On the other hand, pravastatin reduced this parameter, and pitavastatin also showed a slight improvement in HOMA-IR.

The overall conclusion of the study was that statins tend to increase both HbA1c and HOMA-IR levels in individuals without diabetes when compared to placebo. Pitavastatin and pravastatin may have lesser of an effect than other statins.

Optimizing lifestyle measures, including regular exercise, maintaining a healthy body weight, and making healthy food choices is a great first step to improving your health and lowering your cholesterol levels. For some, these changes will not be enough to get cholesterol levels down to normal levels.

Everyone is different. Talk to your healthcare provider of the risk and benefits of statin therapy to decide the best course of treatment for you. Your healthcare provider will likely use a tool like a ASCVD Risk Calculator to determine your long-term risk of heart disease to help decide the risk-benefit of statin therapy.

Together, you and your healthcare provider can develop a plan to get your cholesterol levels under control to help reduce your risk.

Try Zypitamag today—Claim your free 30-day offer.
Call 800-810-7790

Don't have a prescription?
Download and fill out the form and we can request one from your healthcare provider on your behalf.

Not reaching your cholesterol goals?

What should you do if you are not achieving your cholesterol goals, but don't want to move to a high-intensity statin due to concerns of increases in blood glucose levels?

If you are not at your goal with your current statin, consider combination therapy like ezetimibe.

A recent clinical trial published in 2023 looked at a moderate intensity statin with ezetimibe compared to a high-intensity statin.

This study showed that patients taking the moderate intensity statin with ezetimibe had better adherence and were more likely to achieve their LDL-C goals.5

The good news for you is ezetimibe is available through our pharmacy for less than $6/month when you buy a year supply.

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1 Gumprecht J et al. Comparative long-term efficacy and tolerability of pitavastatin 4 mg and atorvastatin 20–40 mg in patients with type 2 diabetes mellitus and combined (mixed) dyslipidemia. Diabetes, Obesity and Metabolism. 2011;13:1047-1055
2 Carmena R and Betteridge DJ. Diabetogenic Action of Statins: Mechanism. Current Atherosclerosis Reports. 2019;21(6):23.
3 Cui JY et al. Statin therapy on glycemic control in type 2 diabetic patients: A network meta-analysis. Journal of Clinical Pharmacy and Therapeutics. 2018;43(4):556-570.
4 Alvarez-Jimenez L. et a. Effects of statin therapy on glycemic control and insulin resistance. A systemic review and meta-analysis. European Journal of Pharmacology. 2023;947:175672.
5 Kim BK et al. Long-term efficacy and safety of moderate-intensity statin with ezetimibe combination therapy versus high-intensity statin monotherapy in patients with atherosclerotic cardiovascular disease (RACING): a randomized, open-label, non-inferiority trial. The Lancet. 2022;400(10349):380-390.