A friend told huazi that he had diabetes, and his doctor suggested that he take statins to prevent cardiovascular and cerebrovascular complications. But he saw an article saying that statins can cause abnormal blood sugar and worsen the control of blood sugar in diabetic patients. So he hesitated and asked huazi, can people with diabetes take statins?
Huazi's answer to him is to follow the doctor's advice and take statins. For people with diabetes, the cardiovascular and cerebrovascular benefits of statins far outweigh the risk of abnormal blood glucose.
1、 Statins have protective effects on cardiovascular and cerebrovascular diseases
Many clinical trials have confirmed that statins have an important protective effect on cardiovascular and cerebrovascular diseases. Statins play a protective role mainly through two ways: one is to regulate blood lipid and reduce the level of low-density lipoprotein cholesterol (LDL-C); the other is to improve the metabolism of arterial intima, resist the oxidative reaction and inflammatory stress reaction caused by LDL-C, strengthen the atherosclerotic plaque, and make the plaque become stable and not easy to break 。
Although other lipid-lowering drugs can also regulate blood lipid and reduce LDL-C, they lack the effect of improving arterial intima and stabilizing plaque. therefore At present, no other drugs can completely replace the protective effect of statins on cardiovascular and cerebrovascular diseases 。 As long as no serious adverse reactions occur, the high-risk population of cardiovascular and cerebrovascular diseases need to take statins for a long time.
2、 Diabetes patients should pay attention to the protection of cardiovascular and cerebrovascular
Diabetes is a metabolic disease with hyperglycemia as the main manifestation, which is caused by the disorder of islet function. Insulin plays an important role in regulating glucose and lipid. Therefore, in most patients with diabetes, dysglycemia is accompanied by dyslipidemia.
In the treatment of diabetes, there is a treatment theory that "almost all diabetic patients need to add statins". that is because Macrovascular complications caused by diabetes mellitus are the main causes of disability and death in diabetic patients About 70% of diabetic patients will eventually die of macroangiopathy.
The mechanism of this disease is that hyperglycemia and hyperlipidemia will cause arterial intima damage, and LDL-C will enter the arterial intima from the injured site, forming atherosclerotic plaque, and finally cause arterial occlusion and disease.
and Statins can reduce the level of LDL-C and play an important role in atherosclerosis 。 When the LDL-C in the blood is reduced to 2.0 mmol / L, LDL-C will not enter the arterial intima; when the LDL-C in the blood is reduced to 1.8 mmol / L, the LDL-C in the arterial intima will flow back to the blood. therefore It is important to reduce the level of LDL-C to delay the progression of atherosclerosis 。
3、 The effect of statins on blood glucose
In the process of using statins, it will cause abnormal blood glucose in patients, such as increased fasting blood glucose, new onset diabetes, deterioration of diabetic blood glucose control, etc. Statins cause abnormal blood glucose, which mainly occurs in high-dose use 。 Due to the genetic differences, European and American people need to use a large dose of statins to be effective, while Chinese people are more sensitive to statins, and the ideal effect can be achieved by using low and medium doses.
therefore The probability of abnormal blood glucose is not high for Chinese people who usually use low-dose statins 。 In addition, among statins, there are low-intensity statins which have a weak impact on blood glucose, but the corresponding ability to regulate blood lipids is also weak. People with low blood lipid levels can choose low-intensity statins under the guidance of doctors.
but For people with high blood lipid levels, statins should be used from the perspective of protecting cardiovascular and cerebrovascular diseases 。 After all, we have a lot of drugs to regulate blood sugar. When blood sugar changes, adjust the hypoglycemic drugs to control. For the protection of cardiovascular and cerebrovascular, there is no other drug can completely replace statins.
If the risk of abnormal blood glucose caused by statins is regarded as "1", then its cardiovascular and cerebrovascular protection is "9" 。 Therefore, diabetic patients should insist on taking statins, but In the course of taking, blood glucose should be closely monitored and the hypoglycemic drugs should be adjusted according to the changes of blood glucose 。
To sum up, diabetic patients need to pay attention to the protection of cardiovascular and cerebrovascular, can take statins. In the process of taking medicine, we should pay attention to the monitoring of blood glucose value, through the adjustment of hypoglycemic drugs, anti statins may cause abnormal blood glucose. It is suggested that the use and adjustment of statins and hypoglycemic drugs should be carried out under the guidance of doctors. Please consult your doctor or pharmacist if you find any problems in the course of medication. I am a pharmacist, welcome to pay attention to me and let me be the pharmacist around you.
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