Do Statins Raise Blood Sugar? A Cardiologist Explains the Connection
A cardiologist explains whether the cholesterol meds can raise blood sugar, who may be most affected and how to support your health while taking them
Key Takeaways
- Statins can slightly raise blood sugar, but the increase is usually small.
- Your heart disease risk helps determine if statins are still the best choice.
- Healthy habits and regular checkups can help manage blood sugar on statins.
If you’re one of the 71 million Americans Johns Hopkins Medicine says are living with high cholesterol, you likely have a lot of questions, including ones about one of the most commonly used medications to treat it: statins. And if you’re one of millions of Americans living with prediabetes or diabetes, you may also be wondering whether statins raise blood sugar. We spoke to a top cardiologist to break down everything you need to know about statins and blood sugar.
What are statins?
“Statins are medications that lower LDL or bad cholesterol, one of the major contributors to plaque buildup in the arteries,” explains Kardie Tobb, DO, MS, FASPC, FACC, a board‑certified preventive cardiologist and the medical director for the Cone Health HeartCare Women’s Heart Health and Cardio-Obstetrics Clinic. “They work by blocking an enzyme in the liver that’s needed to make cholesterol. As a result, the liver pulls more LDL cholesterol out of the bloodstream, lowering cholesterol levels and slowing the progression of atherosclerosis. But statins do more than lower cholesterol. They also help stabilize plaque, making it less likely to rupture and cause a heart attack or stroke.”
Do statins raise blood sugar?
Although many people do well with statins, you’ve likely heard about some of the more commonly reported side effects, such as muscle soreness and increased liver enzymes. And yes, elevated blood sugar can be one of them too.
Woman's World Answers
“Statins can cause a modest increase in blood sugar in some people,” says Dr. Tobb. “For most individuals, the increase is small, often only a few points in fasting glucose or a slight rise in A1C. We don’t completely understand why this happens, but research suggests statins may slightly reduce the body’s sensitivity to insulin or modestly affect insulin secretion from the pancreas.”
What does this mean for you?
If you’re already on a statin or considering taking one, you’re likely wondering what the connection between elevated blood sugar means for you and your health. The answer is it depends.
People with prediabetes, a family history of diabetes, metabolic syndrome, obesity or already elevated fasting blood sugar are more likely to experience the blood sugar effects of statins, explains Dr. Tobb.
Still, Dr. Tobb says many of those people are also at high risk for heart disease because of those same conditions and could still benefit from statins.
“It’s important to keep the entire picture in mind,” she says. “A small increase in blood sugar is generally much less dangerous than a heart attack or stroke that might otherwise have been prevented.”
Should you stop taking statins?
Dr. Tobb says the best course of action when deciding if statins make sense for you is speaking with your healthcare provider to assess your overall risk and determine the best treatment plan. For example, if you develop elevated blood sugar while taking a statin, your provider can help you decide whether improving your lifestyle habits, better managing your blood sugar or making changes to your statin treatment could help. She adds that many people don’t need to stop taking statins altogether, and in some cases, switching to a different statin may be the better option.
“Higher-intensity statin therapy appears to have a slightly greater effect on blood sugar than moderate-intensity therapy,” says Dr. Tobb. “Some studies have also suggested that atorvastatin and rosuvastatin may be associated with a somewhat higher diabetes risk than pravastatin, although the differences are relatively modest.”
And if you and your healthcare provider decide statins aren’t the best fit for you, Dr. Tobb says other cholesterol-lowering medications that don’t appear to worsen blood sugar are available, including:
- Ezetimibe
- PCSK9 inhibitors (like Repatha or Praluent)
- Inclisiran
- Bempedoic acid
3 tips to manage your blood sugar while on a statin
If statins are still the best option for you to manage your heart and cholesterol health, but you’re still worried about keeping your blood sugar in check, Dr. Tobb provides three tips:
Prioritize nutrition
Dr. Tobb recommends following a diet rich in legumes, whole grains, veggies, healthy fats, lean proteins and minimally processed foods to not only support your blood sugar but also your cholesterol.
Stay active
Even just 30 minutes a day or 150 minutes per week of moderate exercise can help improve your insulin sensitivity, says Dr. Tobb. Adding the resistance training activity of your choosing into the mix may provide even more benefits, she continues.
Keep up with your lab work
Staying on top of your blood work and appointments to monitor your weight, blood sugar, blood pressure and cholesterol can help your healthcare provider spot changes early and adjust your treatment plan if needed, explains Dr. Tobb.
The bottom line on statins and blood sugar
If you’re hearing about the connection between statins and elevated blood sugar for the first time, it may feel overwhelming. You thought statins would be the ticket to better health, and suddenly you have another concern to think about. But the truth is most medications are not without potential side effects, and statins don’t cause elevated blood sugar in everyone who takes them. By understanding the potential connection and staying informed about ways to support your blood sugar and overall well-being, you’re taking an important step toward protecting your heart and yourself.
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