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The exact mechanism responsible for the possible increased risk of diabetes mellitus associated with statin use is unclear. [105] However, recent findings have indicated the inhibition of HMGCoAR as a key mechanism. [109] Statins are thought to decrease cells' uptake of glucose from the bloodstream in response to the hormone insulin. [105]
A small increased risk of raised blood sugar levels and the development of type 2 diabetes have been reported with the use of statins. A 2010 published meta-analysis found for every 255 patients taking a statin for 4 years, one additional case of diabetes would occur whilst preventing 5.4 major coronary events. [27]
Gestational diabetes – Gestational diabetes, is a temporary condition that is first diagnosed during pregnancy. Like type 1 and type 2 diabetes, gestational diabetes causes blood sugar levels to become too high. It involves an increased risk of developing diabetes for both mother and child.
Apples. The original source of sweetness for many of the early settlers in the United States, the sugar from an apple comes with a healthy dose of fiber.
Statins with shorter half-lives are more effective when taken in the evening, so their peak effect occurs when the body's natural cholesterol production is at its highest. A recent meta-analysis suggested that statins with longer half-lives, including atorvastatin, may also be more effective at lowering LDL cholesterol if taken in the evening. [40]
The effects of rosuvastatin on low-density lipoprotein (LDL) cholesterol are dose-related. Higher doses were more efficacious in improving the lipid profile of patients with hypercholesterolemia than milligram-equivalent doses of atorvastatin and milligram-equivalent or higher doses of simvastatin and pravastatin.
The affinity of statins for HGMR enzyme is in the nanomolar range, while the natural substrate's affinity is in the micromolar range. [10] Studies have shown that statins use the conformational flexibility of the HMGR enzyme that causes a shallow hydrophobic groove that the statins exploit and is used to accommodate their hydrophobic moieties. [11]
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