FoundMyFitness · 2015-10-16 · Rhonda Patrick (host), Ronald Krauss
Dr. Ronald Krauss on LDL Cholesterol, Particle Size, Heart Disease & Atherogenic Dyslipidemia
38 claims checked against research: 2 overstated 2 needing context 33 supported 1 unverified
2 Overstated
Statins cause an approximate 11% to 12% increased risk of developing type 2 diabetes among users.
"The magnitude of that effect turns out to be surprisingly high. It's um something on the order of 11 to 12% of statin users um are at risk for developing type 2 diabetes." (said at 1:02:07)
Meta-analyses of large randomized controlled trials demonstrate that statin therapy is associated with a ~9% to 12% relative risk increase in new-onset type 2 diabetes (e.g., Sattar et al. 2010 found an OR of 1.09; Preiss et al. 2011 found an OR of 1.12 for intensive vs. moderate statin therapy; CTT Collaboration 2024 found an RR of 1.10 for low-to-moderate intensity statins). However, the speaker states that '11 to 12% of statin users are at risk for developing type 2 diabetes', conflating a relative risk increase (~11-12%) with the absolute proportion of users who develop diabetes. In absolute terms, statins increase the incidence of diabetes by only ~0.1% to 0.2% per year (1 additional case per 255 to 500 patients treated over 4–5 years), primarily in individuals who already have pre-existing risk factors or elevated baseline glycaemia.
- supports: Statins and risk of incident diabetes: a collaborative meta-analysis of randomised statin … (Lancet (London, England) 2010) · cited 2467x in the literature
"Statin therapy was associated with a 9% increased risk for incident diabetes (odds ratio [OR] 1.09; 95% CI 1.02-1.17), with little heterogeneity (I(2)=11%) between trials." (abstract, results, passage verified)
pubmedfull study (doi) - supports: Risk of incident diabetes with intensive-dose compared with moderate-dose statin therapy: … (JAMA 2011) · cited 1397x in the literature
"Odds ratios were 1.12 (95% confidence interval [CI], 1.04-1.22; I(2) = 0%) for new-onset diabetes and 0.84 (95% CI, 0.75-0.94; I(2) = 74%) for cardiovascular events for participants receiving intensive therapy compared with moderate-dose therapy." (abstract, results, passage verified)
pubmedfull study (doi) - supports: Effects of statin therapy on diagnoses of new-onset diabetes and worsening glycaemia in la… (The lancet. Diabetes & endocrinology 2024) · cited 152x in the literature
"Compared with placebo, allocation to low-intensity or moderate-intensity statin therapy resulted in a 10% proportional increase in new-onset diabetes (2420 of 39 179 participants assigned to receive a statin [1·3% per year] vs 2214 of 39 266 participants assigned to receive placebo [1·2% per year]; rate ratio [RR] 1·10, 95% CI 1·04-1·16), and allocation to high-intensity statin therapy resulted in a 36% proportional increase" (abstract, results, passage verified)
pubmedfull study (doi)
In women, the risk of developing type 2 diabetes from statin therapy can be up to three or four times higher, reaching as many as 30% to 40% in otherwise healthy women.
"In women in particular—we published the paper that sort of opened this up, actually—um in women, the evidence is that may be two or three or four times that. It may be as many as 30 to 40% of otherwise healthy women who are put on statins um uh could go on to develop type 2 diabetes over over time." (said at 1:02:20)
The speaker references the landmark Women's Health Initiative (WHI) study led by Culver et al. (2012), but significantly overstates both the relative and absolute risks. In the WHI paper, statin use among postmenopausal women was associated with a 48% increase in risk (multivariate-adjusted HR 1.48, 95% CI 1.38–1.59; unadjusted HR 1.71), not a 2- to 4-fold (200% to 400%) increase. Furthermore, the absolute rate of incident diabetes in statin users in this cohort was far below the claimed 30% to 40%. Large meta-analyses of randomized controlled trials (such as CTT Collaboration 2024) confirm a much smaller relative increase: 10% for low-to-moderate-intensity statins (RR 1.10) and 36% for high-intensity statins (RR 1.36), occurring primarily in individuals who already have elevated baseline glycemic risk factors.
- partial: Statin use and risk of diabetes mellitus in postmenopausal women in the Women's Health Ini… (Archives of internal medicine 2012) · cited 447x in the literature
"Statin use at baseline was associated with an increased risk of DM (hazard ratio [HR], 1.71; 95% CI, 1.61-1.83). This association remained after adjusting for other potential confounders (multivariate-adjusted HR, 1.48; 95% CI, 1.38-1.59) and was observed for all types of statin medications." (abstract, results, passage verified)
pubmedfull study (doi) - contradicts: Effects of statin therapy on diagnoses of new-onset diabetes and worsening glycaemia in la… (The lancet. Diabetes & endocrinology 2024) · cited 152x in the literature
"Compared with placebo, allocation to low-intensity or moderate-intensity statin therapy resulted in a 10% proportional increase in new-onset diabetes (2420 of 39 179 participants assigned to receive a statin [1·3% per year] vs 2214 of 39 266 participants assigned to receive placebo [1·2% per year]; rate ratio [RR] 1·10, 95% CI 1·04-1·16), and allocation to high-intensity statin therapy resulted in a 36% proportional increase (1221 of 9935 participants assigned to receive a statin [4·8% per year] vs 905 of 9859 participants assigned to receive placebo [3·5% per year]; 1·36, 1·25-1·48)." (abstract, results, passage verified)
pubmedfull study (doi)
Unverified means no publication matching the claim was located; it does not prove the claim false. Spotted an error? See the corrections policy - disputes from the people quoted are prioritized.