Thank you for your comment. You mentioned that I have misinterpreted the 2016 Lancet review and that “The Jupiter study did find a slight increase in Diabetes diagnoses in the statin groups but it was 1-2/100,000 not 5-10.” May I know if you are suggesting that I misinterpreted the Lancet review (ref. 1 below), which I referenced in my article, or the 2008 Jupiter study (ref. 2), which was cited in the 2016 Lancet review? And by 5-10, are you referring to new cases of diabetes or hemorrhagic stroke?
Nevertheless, I believe I did not misinterpret the review. The authors, in this case, Collins et al., have written, in the review, “typically, treatment of 10 000 patients for 5 years with an effective regimen (eg, atorvastatin 40 mg daily) would cause about 5 cases of myopathy (one of which might progress, if the statin therapy is not stopped, to the more severe condition of rhabdomyolysis), 50–100 new cases of diabetes, and 5–10 haemorrhagic strokes.”
This was concluded by the authors after analyzing several studies, including meta-analyses and the Jupiter study you have cited in your comment. I am merely reporting the findings of the authors on the potential adverse effects of long-term statin use.
I have also looked into the 2008 Jupiter study. In this paper, the authors have reported the newly diagnosed diabetes cases to be 270/8901 in the statins group and 216/8901 in the control group, giving rise to an excess of 54 diabetes diagnoses in the statins group. Perhaps you may be right that I still lack the knowledge and experience to interpret these data. In this case, would you kindly share your expertise on how you derive the data you have presented (i.e., 1-2/100,000)?
Furthermore, the Jupiter study was designed to investigate the beneficial effect of statins, specifically Rosuvastatin, on preventing the first major cardiovascular events but not on the potential adverse effects caused by using Rosuvastatin or other statins (e.g., atorvastatin or simvastatin). They have also noted that “further study is needed before any causative effect can be established or refuted” as the diabetes diagnoses were based on physician reports and not adjudicated by the end-point committee.
Also, the Jupiter study was prematurely terminated, with a median follow-up of 1.9 years which may potentially exclude diabetes diagnoses occurring in the later years.
Lastly, since you mentioned microvascular pathology as “the main cause Type 2 diabetic mortality,” I presume you meant diabetes microvascular pathology. Based on my understanding, diabetes-associated microvascular complications are a sequel to diabetes, which means it generally occurs in patients who already have diabetes. I am aware that in my article, I wrote that the use of statins (e.g., 40 mg of Atorvastatin) would be expected to cause 50-100 new cases of diabetes. Hence, I do not quite understand what you meant by, “Most importantly, microvascular pathology (the main cause Type 2 diabetic mortality) was reduced significantly in the statin groups.” Would you mind elaborating on this point?
I hope to promote scientific literacy and will not want to contribute to the misinformation on the web. Hence, I always strive to provide the most accurate information possible to the public. However, I do not deny the possibility of missing out on something or misinterpreting when reporting the findings of the medical literature. As such, I would greatly appreciate it if you would take the time to elaborate on your points and provide me with constructive feedback so I can improve my understanding and the accuracy of my articles. Thank you for your time. :)
Reference:
1. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)31357-5/fulltext
2. https://www.nejm.org/doi/full/10.1056/NEJMoa0807646