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New Treatment Advice for Diabetics

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Most diabetics, regardless of their cholesterol levels, should be taking cholesterol-lowering drugs to reduce their risk of a heart attack, the American College of Physicians says.

The organization, which represents more than 100,000 internists, issued new guidelines on how to treat the 18 million Americans with type 2 diabetes.

Simply having diabetes makes a man two to four times more likely to have a heart attack or stroke than someone without the disease. Diabetes makes a woman's risk of a heart attack two to six times greater. Researchers say that's because a diabetic's blood is thicker and more prone to clot.

The new guidelines say diabetics should take cholesterol-lowering statins - even if their cholesterol levels are good - if they have any one of the following health problems: high blood pressure, obesity, smoking, or a family history of heart disease.

Dr. Richard Nesto, chairman of cardiovascular medicine at the Lahey Clinic in Burlington, Mass., told ABCNEWS that a diabetic's arteries are unusually inflamed.

"A cholesterol level in a diabetic patient exists in a person who has chronic inflammation," he said. "That makes this cholesterol much more dangerous to the blood vessel. Furthermore, statins are very good not only at lowering cholesterol but lowering the inflammation."

Statins - drugs such as Lipitor, Zocor, Pravachol and Mevecor, - are among the biggest-selling prescription medications, and although they're advertised as heart medications preliminary research suggests they might treat or prevent many other diseases, including Alzheimer's disease.

Observational studies have found that people who took statins were up to 70 percent less likely to develop dementia. The federal government is now funding a large clinical trial to test the idea. "Statins do have an effect on cholesterol and cholesterol is in the brain," said Dr. Ronald Petersen, director of Alzheimer's research at the Mayo Clinic in Rochester, Minn. "They [the drugs] may also have an effect on the protein called 'amyloid,' which is thought to be a major culprit in the development of Alzheimer's disease."

Statins have also shown early promise against autoimmune diseases such as multiple sclerosis and rheumatoid arthritis. The drugs are being studied in cancer prevention, too, with the results of large clinical trial due later this spring.

Statins do come with risks, including muscle damage that can lead to kidney failure, and liver damage. The side effects are rare, occurring in about one in every 1,000 patients.

But many doctors insist that while potential new uses for statins are being investigated, the drugs should only be prescribed where there is a proven benefit.

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