Too Much Treatment for Diabetic Hearts

Diabetes patients may not get proper treatment to reduce heart disease risk

/ Author:  / Reviewed by: Robert Carlson, M.D

(RxWiki News) To reduce the risk of heart disease in people with diabetes, doctors often prescribe drugs to lower cholesterol. However, these drugs could do more harm than good for some patients.

Researchers found that diabetes patients with no known heart disease may be receiving high doses of cholesterol-lowering drugs, even though they do not need them.

This unnecessary drug treatment may put patients at risk of many complications, including memory loss and liver disease.

"Talk to your doctor about all your prescription drugs."

Type 2 diabetes increases the risk of heart disease. For this reason, it is common for diabetes patients to receive statin drugs to lower cholesterol to specific levels. But recent research suggests that these particular goals may not be good for every patient.

Eve Kerr, MD, of the University of Michigan Health System and VA Ann Arbor Healthcare System, and colleagues found that doctors may be over-prescribing statins to some diabetes patients.

Results showed that 85 percent of diabetic veterans aged 50 to 75 years received appropriate care, mainly because they were taking moderate doses of statins. However, almost 14 percent of patients aged 18 and older with no known heart disease were receiving high-dose statins.

Earlier this year, the FDA released new guidelines for the use of statin drugs. The guidelines warn that statins can cause memory loss, high blood sugar, type 2 diabetes, muscle damage and liver disease.

"We want patients to get the treatment they need to prevent heart attacks and cardiovascular issues but we don't want to expose them to additional treatment risks without strong evidence of the benefits," said Dr. Kerr.

"We need to move away from a one-size-fits-all performance measure that misses the point of providing appropriate treatment," she said.

Doctors typically try to lower cholesterol to below 100 mg/dl for all diabetes patients. However, the study by Dr. Kerr and colleagues supports a more individualized approach. That is, before prescribing high-dose statins, doctors should assess the patient's need for such treatment. While one patient may need to dramatically lower cholesterol levels, another may only need to mildly lower cholesterol levels.

According to the study's authors, this personalized approach is made possible by modern electronic record systems that keep track of blood pressure, prescriptions and other data that tell doctors each patient's risk of heart disease.

"The study reveals that we may have both underuse and overuse of statins and should invigorate efforts to make sure that each patient has the opportunity to be treated in a personalized way that is best given their risk [of heart disease]," said Harlan M. Krumholz, MD, of Yale-New Haven Hospital Center for Outcomes Research and Evaluation and editor of Circulation.

The study included over 960,000 Veterans Affairs patients aged 18 and older with type 2 diabetes. The study was funded by Veteran Affairs, Veteran Affairs Diabetes Quality Enhancement Research Initiative and the National Institute of Diabetes and Digestive and Kidney Diseases. The authors reported no conflicts of interest.

The study appears in the January issue of Circulation: Cardiovascular Quality and Outcomes, a journal of the American Heart Association. 

Reviewed by: 
Review Date: 
December 19, 2012
Last Updated:
December 27, 2012