Lipitor clearly worsening glucose control

Rick,

I do not take Lipitor but I know one woman who did. Her BG went way high
to 20 (360). I do not know the details. Anyway, she went to her doctor,
who said that it was not suppose to happen. Then she spoke to the
pharmacist, who told her about the same thing. She finally phoned the
company. They told her that a small percentage (10% ?) have problems with
BG when on Lipitor. Her question is why was it not mentioned on their
paper.

Françoise.

Rick said:

I have either unconfirmed T II diabetes (never had the required second
reading > 126 mg/dl or DB symptoms),or impaired glucose tolerance.

I do reasonably frequent fingerstick testing, especially when I get an
uncharacteristic result. A year ago I started Lipitor 10mg. Within
weeks, it cut my LDL dramatically, to 67. HDL remained at about 60.
I had a few early side effects, notably mild thigh aches and perhaps
some fatigue. But just as these side effects were abating, I was
startled to see my glucose control start to suddenly worsen. For
years, presumably by sustaining my weight loss, I had always remained
in the nondiabetic -- and usually nonimpaired -- range for both
postprandial and fasting glucose. Suddenly I was seeing much higher
postprandial readings than usual (especially after high simple-carb
meals); plus slower return to normal levels after eating; and fasting
glucose inching into the impaired range.

I quit the Lipitor, and over the next week or two my glycemic control
gradually reverted back to pre-Lipitor patterns and stayed there.
Then I went on Pravachol without any similar loss of glycemic control,
but the LDL quickly climbed and was at 116 a year later, even at the
max dose of 40 mg.

So, thinking my initial experience with Lipitor may have been a fluke,
I asked my doctor to let me try 10 mg Lipitor again. Sure enough, it
turned out to be complete repeat of my year-ago experience in every
way -- big decrease in LDL, but also notable worsening of glucose
control after a few weeks.

Has anyone had a similar experience on Lipitor? While my reaction may
be atypical, I can't believe I'm the only one who has experienced it.
I wonder if there are some folks who experience changes in glycemic
control but neither they nor their doctors even consider that it might
be Lipitor-related, and try withdrawing or replacing it for awhile to
test the possibility. Or perhaps glucose changes of the magnitude I
experienced aren't as noticeable for folks who have higher baseline
glucose?

BTW, Lipitor itself doesn't seem to raise my glucose, i.e if I take a
Lipitor tablet in the fasting state my blood sugar doesn't rise over
the next few hours. The effect seems strictly related to glucose
metabolism.

Thanks in advance for any comments.

Rick

Françoise <[email hidden]> wrote in message news:<[email hidden]>...

Quoted message said:

Rick,

I do not take Lipitor but I know one woman who did. Her BG went way high
to 20 (360). I do not know the details. Anyway, she went to her doctor,
who said that it was not suppose to happen. Then she spoke to the
pharmacist, who told her about the same thing. She finally phoned the
company. They told her that a small percentage (10% ?) have problems with

BG when on Lipitor. Her question is why was it not mentioned on their
paper.

Fran oise.

Do you know what happened after that? Did her BG drop back down when
she stopped Lipitor? Did she switch to a different statin without the
same problem?

Rick

[email hidden] (Herman Rubin) wrote in message news:<[email hidden]>...

Quoted message said:

In article <[email hidden]>,

BL 1204 said:

Quoted message said:

hey told her that a small percentage (10% ?) have problems with=

Quoted message said:

Quoted message said:

BG when on Lipitor. Her question is why was it not mentioned on their
paper.

Quoted message said:

That would be my question too. If ten percent of people have this problem I
would think that eveyrone on the drug should test blood sugars regularly. And
it *should* be in the PDR. I think I would contact the FDA on this one.

A small percentage would be on the order of 1%, and even less
than that causes mention in the PDR.

Hyperglycemia (as well as hyoglycemia) is indeed listed in the rare
adverse effects section of the Lipitor monograph -- the section that
tends to be a laundry list of potential adverse effects.
Interestingly, unlike most modern monographs, anything with < 2%
incidence is thrown into this category instead of the usual <1%.
Also, I notice that this is one of those monographs that uses a
"regardless of causality" statement for the rare effects instead of
"causality has not been established." Maybe it's just inconsistent
wording on the part of various monograph writers, but those two
satements do *not* say the same thing.

In any event, my purpose here was not to suggest the manufacturer is
trying to cagily hide or downplay a real effect (although that's by no
means an unprecedented event with Big Pharma). Rather, my purpose was
primarily to see if others have experienced this Lipitor-induced
adverse effect on glycemic control, and secondarily to suggest that it
may deserve further clinical investigation. I wonder if everyone in
the original placebo-controlled clinical trials -- whether diabetic or
not -- had some sort of pre-and-post glucose testing?

Rick

I heard from a doctor about a study that showed that statins increase blood
glucose in diabetics. Unfortunately, no mention of this appears in the
abstract for the study, so it is very difficult to find.

"Rick" <[email hidden]> wrote in message
news:[email hidden]...

Quoted message said:

I have either unconfirmed T II diabetes (never had the required second
reading > 126 mg/dl or DB symptoms),or impaired glucose tolerance.

I do reasonably frequent fingerstick testing, especially when I get an
uncharacteristic result. A year ago I started Lipitor 10mg. Within
weeks, it cut my LDL dramatically, to 67. HDL remained at about 60.
I had a few early side effects, notably mild thigh aches and perhaps
some fatigue. But just as these side effects were abating, I was
startled to see my glucose control start to suddenly worsen. For
years, presumably by sustaining my weight loss, I had always remained
in the nondiabetic -- and usually nonimpaired -- range for both
postprandial and fasting glucose. Suddenly I was seeing much higher
postprandial readings than usual (especially after high simple-carb
meals); plus slower return to normal levels after eating; and fasting
glucose inching into the impaired range.

I quit the Lipitor, and over the next week or two my glycemic control
gradually reverted back to pre-Lipitor patterns and stayed there.
Then I went on Pravachol without any similar loss of glycemic control,
but the LDL quickly climbed and was at 116 a year later, even at the
max dose of 40 mg.

So, thinking my initial experience with Lipitor may have been a fluke,
I asked my doctor to let me try 10 mg Lipitor again. Sure enough, it
turned out to be complete repeat of my year-ago experience in every
way -- big decrease in LDL, but also notable worsening of glucose
control after a few weeks.

Has anyone had a similar experience on Lipitor? While my reaction may
be atypical, I can't believe I'm the only one who has experienced it.
I wonder if there are some folks who experience changes in glycemic
control but neither they nor their doctors even consider that it might
be Lipitor-related, and try withdrawing or replacing it for awhile to
test the possibility. Or perhaps glucose changes of the magnitude I
experienced aren't as noticeable for folks who have higher baseline
glucose?

BTW, Lipitor itself doesn't seem to raise my glucose, i.e if I take a
Lipitor tablet in the fasting state my blood sugar doesn't rise over
the next few hours. The effect seems strictly related to glucose
metabolism.

Thanks in advance for any comments.

Rick

"Sharon Hope" <[email hidden]> wrote in message news:<dd_sb.145022$9E1.741353@attbi_s52>...

Quoted message said:

I heard from a doctor about a study that showed that statins increase blood
glucose in diabetics. Unfortunately, no mention of this appears in the
abstract for the study, so it is very difficult to find.

Interesting.

I did find one indirect reference on Medline (I don't know how good a
study it was) that seems to metion in passing that the statin Zocor
(simvastatin) raised fasting insulin levels without decreasing fasting
glucose. To me this suggests it encourages hyperinsulinemia while
decreasing insulin sensitivity. I may be missing something here, but
isn't that a formula for exacerbating the metabolic syndrome and T II
diabetes risk, or eventually worsening glycemis control in those who
already have diabetes? I should mention that I've never taken Zocor
and have no idea whether for me it would have the same deleterious
effect on glucose metabolism that Lipitor does. Pravachol certainly
didn't, but it's so much less effective than Lipitor at reducing
cholesterol, and presumably less effective in other ways, such as
preventing atheriosclerosis (Pfizer just recently issued a press
release claiming this).

I've have run across a few small studies that looked at statin effects
on glucose. They generally show no effect. But we're talking
averages (YMMV, as you know). The only one I saw on Lipitor was from
Japan, which is a fairly homogeneous population.

Here's an abstract of the Zocor (simvastatin) study I referred to.
Note a reference near the end to "the fasting insulin-elevating
effect of simvastatin."

JAMA. 2002 Feb 6;287(5):598-605.

Effects of diet and simvastatin on serum lipids, insulin, and
antioxidants in hypercholesterolemic men: a randomized controlled
trial.

Jula A, Marniemi J, Huupponen R, Virtanen A, Rastas M, Ronnemaa T.

Research and Development Centre of the Social Insurance Institution,
Peltolantie 3, FIN-20720 Turku, Finland. [email hidden]

CONTEXT: Limited information exists on the interaction between diet
and 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors
(statins) and the interaction's effect on serum lipid and lipoprotein
levels, insulin sensitivity, and circulating antioxidant vitamin and
provitamin levels. OBJECTIVE: To evaluate the separate and combined
effects of diet and simvastatin therapy on serum levels of lipids,
lipoproteins, antioxidants, and insulin. DESIGN, SETTING, AND
PARTICIPANTS: Randomized, controlled crossover trial conducted from
August 1997 to June 1998 in 120 previously untreated
hypercholesterolemic men aged 35 to 64 years who were recruited from
the community in Turku, southwestern Finland. INTERVENTIONS: After a
4- to 6-week placebo run-in period, participants were randomly
allocated to a habitual diet (n = 60) or dietary treatment group (n =
60), and each of these groups was further randomized in a double-blind
crossover fashion to receive simvastatin (20 mg/d) or placebo, each
for 12 weeks (n = 30 in each group). The main goals of the dietary
treatment were to reduce energy intake from saturated plus
trans-unsaturated fats to no more than 10% by replacing them partly
with monounsaturated and polyunsaturated fats rich in omega-3 fatty
acids and to increase intake of fruits, vegetables, and dietary fiber.
MAIN OUTCOME MEASURES: Changes in levels of total, low-density
lipoprotein (LDL), and high-density lipoprotein (HDL) cholesterol;
triglycerides; apolipoprotein B; insulin; glucose; and antioxidants at
week 12 of each treatment period, compared among the 4 groups.
RESULTS: Dietary treatment decreased levels of total cholesterol by
7.6% (P<.001), LDL cholesterol by 10.8% (P<.001), HDL cholesterol by
4.9% (P =.01), apolipoprotein B by 5.7% (P =.003), serum insulin by
14.0% (P =.02), and alpha-tocopherol by 3.5% (P =.04). Simvastatin
decreased levels of total cholesterol by 20.8%, LDL cholesterol by
29.7%, triglycerides by 13.6%, apolipoprotein B by 22.4%,
alpha-tocopherol by 16.2%, beta-carotene by 19.5%, and ubiquinol-10 by
22.0% (P<.001 for all) and increased levels of HDL cholesterol by 7.0%
(P<.001) and serum insulin by 13.2% (P =.005). Glucose levels remained
unchanged in all groups. The effects of dietary treatment and
simvastatin were independent and additive. CONCLUSIONS: A modified
Mediterranean-type diet rich in omega-3 fatty acids efficiently
potentiated the cholesterol-lowering effect of simvastatin,
counteracted the fasting insulin-elevating effect of simvastatin, and,
unlike simvastatin, did not decrease serum levels of beta-carotene and
ubiquinol-10.

Rick

"Sharon Hope" <[email hidden]> wrote in message news:<dd_sb.145022$9E1.741353@attbi_s52>...

Quoted message said:

I heard from a doctor about a study that showed that statins increase blood
glucose in diabetics. Unfortunately, no mention of this appears in the
abstract for the study, so it is very difficult to find.

Oops, I forgot to ask...Do you know which study this was? I might be
interested in obtaining the original full article. Could you paste or
provide a link to the abstract? Thanks!

Rick

Rick said:

Do you know what happened after that? Did her BG drop back down when
she stopped Lipitor?

It seems that her BG stayed high and difficult to control at least for a while. I know that
she is on insulin now.

Quoted message said:

Did she switch to a different statin without the
same problem?

I do not know.

Françoise.

Quoted message said:

Rick

Sorry, I do not have it. I heard about it in the context of, although read
by this doctor, it is nearly impossible to find again because the abstract
did not include it.

"Rick" <[email hidden]> wrote in message
news:[email hidden]...

Quoted message said:

"Sharon Hope" <[email hidden]> wrote in message

news:<dd_sb.145022$9E1.741353@attbi_s52>...

Quoted message said:

Quoted message said:

I heard from a doctor about a study that showed that statins increase

blood

Quoted message said:

Quoted message said:

glucose in diabetics. Unfortunately, no mention of this appears in the
abstract for the study, so it is very difficult to find.

Oops, I forgot to ask...Do you know which study this was? I might be
interested in obtaining the original full article. Could you paste or
provide a link to the abstract? Thanks!

Rick