A new study shows that cholesterol is not the reason many diabetics get heart disease and statins may not be enough to prevent heart attacks in people with diabetes.
A study by epidemiology experts at John Hopkins University and published in the journal Circulation show s that heart attacks are the leading cause of death in diabetics.
Researchers noted that people with diabetes may have low cholesterol, therefore the widely prescribed cholesterol-lowering drugs do not work to prevent heart attacks.
This study echoes the theory proposed by the controversial sports scientist Tim Noakes, who disagrees with the widespread use of statins as he claims the cholesterol theory of heart disease is questionable.
"It puts what we know about heart damage in diabetes on its head," said study leader Elizabeth Selvin, an associate professor of epidemiology at the Johns Hopkins Bloomberg School of Public Health.
"It looks like diabetes may be slowly killing heart muscle in ways we hadn't thought of before."
But leading endocrinologist and Wits Professor Derick Raal said people at risk of heart disease must still take cholesterol-lowering drugs.
"Statins are still remarkable drugs and I have seen many patients benefit immensely from them over the past 30 years."
He said international and local guidelines said diabetics must be on statins, regardless of their cholesterol levels, as they were at high risk of heart disease.
The researchers in the new study measured levels of a protein in the blood that is secreted when bits of heart muscle die that better predicted heart disease in diabetics. The test is not commercially available.
"Though there may be no symptoms yet, our research suggests there is microvascular damage being done to the heart that is leading to heart failure and even death" Selvin said.
UCT clinical lipidologist Dirk Blom said there were many risk factors for a heart attack and diabetes was only one.
High cholesterol was another, as was obesity, high blood pressure and smoking.
"You look at all the risk factors when deciding whether to treat people."
Diabetics were not the only people who suffered heart attacks, he said.
"You accept some people with risk factors won't have a heart attack and you also accept some people without them will.
"But we must treat people who are at risk, usually with statins."
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