Statins May Prevent Vision Loss for People with Diabetes

The statin drug you may be taking to lower your "bad" cholesterol could do more than lower your risk of heart attack and stroke due to diabetes. Findings reported in JAMA Ophthalmology suggest that type 2 diabetics taking statins for high cholesterol may experience a lower rate of diabetic retinopathy. Intended to lower the risk of heart disease, future vision benefits could be an added benefit of statins. Statins may reduce the need for treatment of vision loss that is a complication of diabetes,1 and is the leading cause of blindness in working-age adults.2

Population study in taiwan

The findings in a Taiwan population-based study looked at patient data from January 1, 1998 until December 31, 2013 from their National Health Insurance Research Database. Scientists identified and followed more than 37,000 people with type 2 diabetes and high cholesterol.1 The statistical analysis, performed in May 2018, looked at those taking statins and those not taking statins.2 Each evaluated cohort consisted of approximately 19,000 people with type 2 diabetes, one group taking statins and one not. Results: those taking statins were 8% less likely to develop the non-aggressive form of diabetic retinopathy, and 36% less likely to develop proliferative diabetic retinopathy, a more advanced condition.1 This equates to an overall reduced risk of 14% of developing diabetes-related eye disease.2

In the study, those taking statins were less likely to experience retinal detachment or swelling of the macula, the central region of the retina responsible for clear vision.1

Definition of terms

Statins, a class of cholesterol-lowering drugs, are associated with a decreased prevalence of diabetic retinopathy in people with both type 2 diabetes and high cholesterol.

Dyslipidemia is characterized by elevated total cholesterol levels or low-density lipoproteins (LDL); or low levels of high-density lipoproteins (HDL). High cholesterol is an important risk factor for developing coronary heart disease (CHD) and/or stroke.

Diabetes Mellitus is a metabolic disorder that affects the way the body metabolizes glucose (sugar). It affects how the body uses food and converts it to energy. In type 2 diabetes, the body loses the ability to use the insulin hormone it produces effectively. Currently, there is no cure for type 2 diabetes, but healthy eating habits and exercise can help manage the condition. Some people require diabetes medications or insulin therapy to control their illness. Many diabetics watch their blood sugar levels, but don’t pay the same attention to cholesterol.

Diabetic retinopathy is an eye condition characterized by damage to small blood vessels in the retina. These blood vessels may leak fluid into the tissue of the eye resulting in retinal swelling or bleeding. This can result in vision problems.1 In proliferative diabetic retinopathy, a more advanced condition, blood vessels in the retina continue to expand and can increase risk of hemorrhaging or bleeding that can result in sudden and severe vision loss. This more aggressive form can result in retinal detachment and blindness.1

Diabetic retinopathy is typically treated via injection of medication directly into the eye. This procedure can be both distressing and painful. For people taking statins, it appears this treatment may be avoided, or the extent of it minimized.

How do the statins work on the eye?

The way statins impact the retina is not fully understood. It is thought that the process of inflammatory reduction, which reduces the risk of heart attacks, also reduces swelling in the retina.1

Potential benefits

Taking statins could result in added benefit for diabetics with high cholesterol but should not be an excuse to give up healthy habits. Diet and exercise play a key role in managing both diabetes and cholesterol, reducing the risk of heart attack and stroke. Maintaining healthy, normal blood pressure and not smoking also play a role in preserving vision.1

According to the study authors, "Statins may actually help patients' eyeballs as well, not just their hearts,"1 That doesn’t mean you should start taking statins if you don’t have high cholesterol, as there is no data to suggest that statins are effective in lowering risk of retinopathy development if you are not taking them to manage risks for coronary disease.1

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