Statins, Diabetes, and Animal House

For those who haven’t heard, a new study has shown that statins (to treat cholesterol) raise the chances of the person, who is taking the medication, of getting diabetes by 50%.  This is the fourth publication to show that.   It looks like a real risk.  Wow.  So, let me get this straight.  The idiots in the government and the insurance countries want to measure us doctors on quality indicators.  Those indicators include such things as whether a person with high cholesterol is getting treated with a statin.  If we do that, however, then that person may get diabetes.   Another indicator is that all diabetics should be on a statin but you have to wonder if this makes their diabetes worse.   This is like a catch 22 or a conversation from Animal House:

Larry: Okay. That means that our whole solar system could be, like one tiny atom in the fingernail of some other giant being. [Jennings nods] This is too much! That means one tiny atom in my fingernail could be–
Prof. Jennings: Could be one little tiny universe.
Larry: Could I buy some pot from you

That’s the answer!  Medical marijuana.  Ok, I am kidding but this whole “plan” with patients using or overusing statins just might not be perfect yet.  And that is the problem with paying doctors on their patients’ numbers.  P4P (pay for performance)  is a flawed system because the people in charge are unable to be flexible and change quick enough and because what we think we know may not be a fixed law in the universe.

Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  3 comments for “Statins, Diabetes, and Animal House

  1. David Lubin, MD
    January 25, 2012 at 8:21 pm

    Hey, maybe we’re missing the cause and effect here. Maybe we’re practicing great medicine and when someone’s cholesterol is up, maybe diabetes is just waiting to tag along in a few years, like the earth shadowing the sun for it’s entire life. So maybe if you’re cholesterol is up, you’re more at risk to develop diabetes. So, we treat the cholesterol with a statin, you get the frank diabetes you were doomed to get, and it’s blamed on the statin…of course. I believe there’s a study out showing that drinking milk has a great propensity to cause susceptible persons to become serial killers, as analysis shows that 99% of serial killers drank milk as children. Kill the cows.

  2. Semi Retired
    January 25, 2012 at 9:17 am

    How about veterans exposed to agent orange?
    VA is compensating anyone who set foot in VietNam who subsequently develops Type 2 Diabetes and/or Ischemic Heart Disease, no matter what other risk factors.

    • January 25, 2012 at 1:38 pm

      This was one of the smarter things done by the VA. The decision circumvents the political minefield surrounding the Agent Orange claims, and the inadequate associated science, by avoiding a system requiring each veteran to attempt to prove a connection in order to get medical care. It errs on the side of covering all veterans for these problems; problems that clearly require and benefit from ongoing medical care. Without that decision the VA would need to pay for adjudication of disability claims and would still be on the hook for the cost of treating veterans with untreated DM and Ischemic Heart Disease if those claims had been denied. Of course it would be even better if the VA covered all of the medical care of every veteran. Instead some whose butts were on the line, potentially risking life and limb to defend our country, and honorably discharged now must prove service connection in order to get care. I think the VA should cover all of those veterans.

      – a VA orthopaedic surgeon, but unfortunately the contents of this message are mine personally and do not reflect the position of the Government or the Department of Veterans Affairs.

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