The use of cholesterol-lowering statin drugs increases the chance of developing diabetes by 9 percent, but the absolute risk is low, especially when compared with how much statins reduce the threat of heart disease and heart attack, new research shows.
What I find interesting in this article is the audacity to believe the use of statins has had any positive affect on Coronary Heart Disease and thus warrants a pass on the increase in Diabetes!
Let's look at the numbers:
About 12.0 million people of all ages in the United States had diagnosed diabetes, of whom 98% were adults aged 20 and over. This translates to about 4.4% of the total population and 6.0% of the adult population (Centers for Disease Control and Prevention, 2005b; Honeycutt, Boyle, Broglio, et.al., 2003).
Diagnosed Onset: About 880,000 cases of diabetes were newly diagnosed in 1997, and that figure rose to 1.1 million by 2000, of whom more than 96%were adults. This translates to a diagnosis rate among the adult population of about 5.2 per thousand in 2000 (Centers for Disease Control and Prevention, 2005b; Honeycutt, Boyle, Broglio, et.al., 2003).
Recovery: Recovery is a significant factor for many acute illnesses. But for diabetes, as for all chronic diseases that lack a full and permanent cure, it is virtually non-existent.
Death Among those Diagnosed: Diabetes, like other chronic diseases, has a relatively small annual death rate. In 2000, of the 12.0 million people with diagnosed diabetes, about 500,000 (4.2%) died (Honeycutt, Boyle, Broglio, et.al., 2003), including approximately 213,000 deaths (a rate of about 1.8% per year) attributed to complications of the disease (Centers for Disease Control and Prevention, 2005b).
Undiagnosed Prevalence: Since 1976, a random sample of participants in the periodic National Health and Nutrition Examination Survey (NHANES) without a diagnosis of diabetes were selected for a blood glucose test (Kenny, Aubert, Geiss, 1995). By dividing the number of people found to have diabetes by the total number of people tested, researchers estimated the fraction of Americans with diabetes whose disease was undiagnosed for each of the following NHANES periods: 1976-1980: 38%; 1988-1994: 36%; and 1999-2000: 29%(Gregg, Cadwell, Cheng, et.al., 2004).
Initial Onset: There is no actual measure of the rate of initial onset of diabetes (i.e., the number of people per year who develop diabetes) as opposed to the rate of diabetes diagnosis. However, the team estimated the initial onset rate by combining the data described above on diagnosed prevalence, undiagnosed prevalence, and death using the causal logic of Figure 18. According to their estimates, in 2000, 1.25 million U.S. adults experienced the initial onset of diabetes, a rate of 6.0 people per thousand.
Population without Diabetes: This category includes people with normal glycemic levels, as well as people whose moderately elevated blood sugar qualifies them as prediabetic. Based on blood testing data from NHANES 1988-1994, about 40% of Americans aged 40-74 have prediabetes (Centers for Disease Control and Prevention, 2005b; Expert Committee on the Diagnosis and Classification of Diabetes Mellitus, 2003). Extrapolating to the rest of the adult population (taking into account estimated differences in prediabetes prevalence for ages 18-39 and 75+, based on historical data on age-specific diabetes incidence (14), and projecting forward in time, the team estimated that at least 52 million (or 25%) of American adults 18 and over were prediabetic in the year 2000.
What is true is that there has been a reduction in Mortality due to CHD since the onset of statin drugs (roughly the early 90's) at least according to the American Heart Association. But it remains the number one cause of mortality in the USA and has held this spot since the early 1990's. Prior to the 1990's there had been a steady decline in CHD due to better education on risk factors.
Over the the same twenty years the incidence in Type II Diabetes has mushroomed as has the rate of Obesity.
Retrospective analysis of health and social problems illustrates limited success in identifying and dealing with potentially preventable health problems. Recent conclusions from the European Action on Secondary Prevention through Intervention to Reduce Events (EUROASPIRE) II [1] drawn by Wood, who coordinated the study, are relevant here. Among the many disappointing results was the fact that 81% of the individuals surveyed in 1999/2000 were overweight, with a third of them obese. The proportion of obese people increased sharply from 25% in 1995/96, while the number of smokers was unchanged, despite anti-smoking campaigns. Further, 61% of those surveyed had hypertension and 59% had abnormally high cholesterol, despite increased use of antihypertensive and cholesterol lowering drug treatment. Wood argued that the findings revealed "inadequate standard of care" and "a collective failure of the medical practice." He claimed that cardiologists are too focused on acute management and are paying insufficient attention to prevention and long-term treatment.
Again, a key to understanding mortality decline and morbidity increase is the fact that Cardiologists and frankly all Physicians are focused on acute care which saves the life but leaves that life less than healthy.
Work Smarter Not Harder!
Dr David Marcon
Cincinnati, Ohio
drdavidmarcon.com
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