Statins and thiazides can enhance blood sugar, danger of diabetes

Dr. Keith Roach

Pricey Dr. Roach: My query regards the outcomes of my fasting glucose assessments for the previous couple of years. I’m 81 and weigh round 150 kilos. The medicines I’m taking concern me, with relevance to the A1C ranges of my quarterly blood work. My A1C ranges have largely been close to mid 5%; final was 6%. Medicines related to this that I’m suspicious of are 100-12.5 mg of losartan/hydrochlorothiazide (HCTZ) and 20 mg of simvastatin. I’ve learn that these medicines can have an impact of elevating blood glucose. My physician is adamant that this doesn’t exist, nevertheless it appears to me that there’s a battle on this.

Ought to I maybe ask him to vary these medicines due to blood sugar? I’m involved about points with the thiazide and the statin.

— P.R.

Pricey P.R.: There isn’t a battle. You’re completely proper that each simvastatin (like all statins) and HCTZ (like all thiazides) enhance blood sugar and the danger of diabetes. The chance, nevertheless, is small. For thiazides, the danger of excessive blood sugar appears tied to potassium ranges – the decrease the potassium, the upper the danger of diabetes. Curiously, the losartan that’s together with the HCTZ you’re taking tends to boost potassium ranges, in order that mixture could have a decrease danger of worsening blood sugar ranges than taking HCTZ alone. You’re already taking the smallest efficient dose of thiazide.

The chance of statins appears better in larger doses and with stronger statins, like atorvastatin and rosuvastatin; nevertheless, the danger remains to be small. About one particular person in 100 handled with a high-dose intensive statin, resembling 40 mg of atorvastatin for 5 years, could be anticipated to get diabetes, whereas a dosage of 20 mg of simvastatin could be anticipated to have an excellent decrease danger.

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