Statins good for diabetes patients

Statins good for diabetes patients
http://www.theaustralian.news.com.au/story/0,25197,23040318-23289,00.html

CHOLESTEROL-LOWERING drugs called statins should be automatically considered for nearly all patients with diabetes, after a study showed the drugs cut heart attacks and strokes even in people with no prior signs of heart disease.

Australian and British experts analysed the results of 14 previous trials involving a total of 90,000 people, and found that over nearly five years the number of deaths among the nearly 19,000 diabetes patients fell by 9per cent for every one-unit drop in their level of LDL, or "bad" cholesterol.

The drop was almost the same seen in the 71,000 non-diabetic patients, and applied equally to men and women, and both main types of diabetes. Each major cut in LDL cholesterol cut the numbers of heart attacks, strokes and blocked arteries by 21 per cent in diabetic and non-diabetic groups.

Any increase in statin use may place more pressure on the Pharmaceutical Benefits Scheme. One statin drug alone, Pfizer's Lipitor (atorvastatin), was the biggest drain on the PBS in 2005-06, costing the scheme nearly $490 million for 8.5million prescriptions.

The study's authors -- from the National Health and Medical Research Council's Clinical Trial Centre at the University of Sydney and the Epidemiological Studies Unit in Oxford -- said "most people with diabetes should now be considered for statin therapy", with the exception of children and pregnant women. The study was published yesterday in The Lancet.

Jonathan Shaw, deputy director of the Melbourne-based International Diabetes Institute, said the PBS eligibility criteria for statins should be widened.

Currently, diabetes patients only qualify for subsidised statin drugs if they are over 60, or if their blood cholesterol exceeds 5.5 millimoles per litre of blood.

David Sullivan, head of the lipid clinic at Sydney's Royal Prince Alfred Hospital, said the existing PBS rules were a reasonable attempt to balance the benefits of treatment with the costs. However, he said: "I have some sympathy for broadening the criteria."


Diabetes - statin use for all urged
http://www.irishhealth.com/?level=4&id=12855

Most people with diabetes should be given statins - drugs that are used to treat high cholesterol levels - whether they display signs of heart disease or not, the results of a new study indicate.

In the past, there has been some debate about whether statins would produce the same benefits in people with diabetes compared to those with heart disease in general. To investigate this further, a team of researchers at Oxford University in the UK looked at over 90,000 people, 19,000 of whom had diabetes.

They found that people with diabetes who were treated with statins had their risk of cardiovascular events reduced in the same way as people without diabetes, regardless of existing cardiovascular disease.

After five years, for every 1,000 people with diabetes who were treated with statins, almost 50 fewer had experienced major heart problems such as stroke and heart attacks.

Overall, the researchers estimated that daily treatment with statins could prevent about one-third of stroke and heart attacks in people with diabetes.

Only a small number of people with the condition should not be considered for statin therapy, the team said. These include people who cannot take the drugs for certain reasons, such as being pregnant and those who are at exceptionally low risk of heart problems, such as children.

Describing those with diabetes as a 'clearly defined group of people at an increased risk of cardiovascular disease', the researchers believe that statins 'are clearly effective' in people with the condition.

Details of these findings are published in the medical journal, The Lancet.


Most people with diabetes should be considered for statin therapy
http://www.thelancet.com/

At least 170 million people worldwide are estimated to have diabetes mellitus. Researchers from the Cholesterol Treatment Triallists Collaboration at the University of Oxford, UK, did a large meta-analysis which shows how people with diabetes can reduce their risk of cardiovascular events from statin therapy in the same way as people without diabetes, regardless of existing cardiovascular disease. A linked Comment states: 'Statins are among the most notable triumphs of modern medicine…'apart from drug treatment, one must not forget the importance of lifestyle changes, such as cessation of smoking, healthy diet, and regular exercise.'


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Civis Romanus Sum
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