Statins and Thiazides Acutely Increase Blood Sugar, Risk of Diabetes

DEAR DR. ROACH: My question regards the results of my fasting glucose tests for the past couple of years. I am 81 and weigh around 150 pounds. The medications I am taking concern me, with relevance to the A1C levels of my quarterly blood work. My A1C levels have mostly been near mid-5%; the last showed 6%. Medications relevant to this that I am suspicious of are 100-12.5 mg of losartan/hydrochlorothiazide (HCTZ) and 20 mg of simvastatin. I have read that these medications can have an effect of raising blood glucose. My doctor is adamant that this does not exist, but it seems to me that there is a conflict on this. Should I perhaps ask him to change those medications because of my blood sugar? I am concerned about issues with the thiazide and the statin. -- P.R.

ANSWER: There isn’t a conflict. You are absolutely right that both simvastatin (like all statins) and HCTZ (like all thiazides) increase blood sugar and the risk of diabetes. The risk, however, is small. For thiazides, the risk of high blood sugar seems tied to potassium levels -- the lower the potassium, the higher the risk of diabetes. Interestingly, the losartan in combination with the HCTZ you are taking tend to raise potassium levels, so that combination may have a lower risk of worsening blood sugar levels than taking HCTZ alone. You are already taking the smallest effective dose of thiazide. The risk of statins seems greater in higher doses and with more potent statins, like atorvastatin and rosuvastatin; however, the risk is still small. About one person in 100 treated with a high-dose intensive statin, such as 40 mg of atorvastatin for five years, would be expected to get diabetes, while a dosage of 20 mg of simvastatin would be expected to have an even lower risk.

The conflict isn’t whether the increased risk exists (it does), but whether the treatments to prevent heart attack and stroke are worth the increased risk. For nearly all people, the benefit of keeping blood pressure and cholesterol under control greatly outweighs the small increased risk of diabetes. Given your normal A1C level, I would say your risk is low, and I do not generally recommend changing treatment based on your concern over blood sugar.

***

Dr. Roach regrets that he is unable to answer individual questions, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu.

© 2023 North America Synd., Inc. All Rights Reserved

Assistive Devices Help People Remain Mobile

Disabilities affect people from all walks of life. The Centers for Disease Control and Prevention estimates that around 55 million Americans have a disability of some kind. Of these people, 33 million have a disability that makes it difficult for them to carry out some daily activities. Statistics Canada states that, as of 2012, 13.7 percent of the population age 15 years or older reported having a disability that could impact daily life.

People with disabilities may need assistive devices to reclaim some measure of their independence. For example, millions of people rely on wheelchairs or walking aids to get around. These are called assistive technology and rehabilitative devices, which include tools, equipment or products that can help people with disabilities get around more easily. These devices may be as small as magnifying glasses for reading to as large as wheelchairs.

The National Institutes of Health state that 2.2 million people in the U.S depend on wheelchairs for day-to-day tasks and mobility. More than six million use canes, walkers or crutches to assist with mobility.

Assistive devices can be highly effective, but only when they are used properly and safely. Assistive devices should be measured for each user. Many walkers are height-adjustable. The width of a device also is important. A walker or another device that is too wide can affect mobility or require modifications to be made around the home. Weight is another consideration. The device should be lightweight so it can be maneuvered, but also weigh enough to provide enough stability to keep users upright. Users should proceed slowly and favor their stronger sides when relying on canes or walkers. Devices should not be used to climb atop other items like step stools. Children should not be allowed to play with or ride on assistive devices. If there are safety belts or locks on any assistive technology, they should be put in place before use to prevent further injury.

30 North Union St., Rochester, NY 14607

Thursday, March 14 • 11:30am-1:00pm

FREE Cataract Lunch & Learn

Are you considering advanced technology for your cataract surgery?

We’re here to help you on your journey to clearly better vision.

To RSVP call Kim at 585-232-7807 by March 10, 2023.

We are looking for Front

Desk Staff

for a busy surgical dental o ce

Lakeville Perio

Implant & Dental Surgery

Email: lakevillework14480@gmail.com

Opportunities for Entry-level and for those with Experience in our Rochester Division:

CME Associates, Inc. provides Quality Assurance Services for the Construction Industry with material testing and special inspection services.

• Material Testing – Soil, Concrete, Asphalt

• Special Inspections – Reinforced Concrete, Masonry, Fireproo ng, Geotechnical, Structural Steel Welds & Bolting, and more.

Current Opportunities:

• Construction Materials Testing Technician

• Construction (Special) Inspector

• Certi ed Welding Inspector (CWI)

Please visit www.cmeassociates.com to apply or for more information.

Quail Summit is seeking a

Fu - me C k

Honeoye Falls-Lima Central School District IS HIRING

• B shift Cleaners

• Bus Drivers

• Bus Monitors

Hours and pay vary by position. NYS Pension and bene t eligible positions available. To apply, visit: www.work4h .org

Local Avon, NY Manufacturer accepting applications for Full-time

OceSecretary

Monday-Friday • 8:00am-4:40pm

Clerical, ling and general o ce support.

Augmented o ce needs: customer service ll-in, assist other sta , clerical/ ling, and lling in for absent sta .

Minimum of Associate’s degree preferred. Minimum 5 years’ o ce experience required. Excel Sheet & Word Document pro cient.

Starting wage $17-$18.50 per hour, negotiable based on experience & education.

PTO per company handbook, Paid Recognized Holidays. Elective Bene ts include: 401K, medical, dental, life insurance. Eligible for $250 sign-on bonus at 90 days employment. EAP, Long & Short term disability.

Apply in person at 495 Rochester St., Avon, NY or email H-R@graymetal.com

To join our team in providing a high quality, enjoyable dining experience for our community of independent seniors. Candidates’ prior experience in a restaurant or professional establishment will compliment our team. Quail Summit o ers a generous bene ts package and excellent work environment.

Please send resume to:

Liz Slater, Assistant Executive Director lslater@quailsummit.com

OR apply at 5102 Parrish St. Ext., Canandaigua

Local Avon, NY Manufacturer accepting applications for Customer

Service Position

• Requires good data entry skills

• Communicating with customers

• Filing

• Minimum associate’s degree preferred

• Minimum 5 years’ o ce experience

• Excel & Word document pro cient

Starting pay $16.50/hr, negotiable based on education & experience.

Hours: M-F 8:00am-4:30pm.

PTO per company handbook, Paid Recognized Holidays. Elective Bene ts include: 401K, Medical, Dental, Life Insurance. Eligible for $250 Sign-on Bonus at 90 days employment. EAP, Long and Short Term Disability.

Apply in person at 495 Rochester St., Avon, NY or email H-R@graymetal.com

Local Avon, NY Manufacturer accepting applications for Full-Time B Shi

Monday – ursday 5:30PM-2AM and Fridays 3PM-11:30PM.

Bene ts include: $250 sign-on bonus, PTO, paid recognized holidays, 401K, medical, dental, life insurance, EAP, long and short term disability

Positions available:

Production Workers

Hourly Starting Compensation: $16.75-$17.25

Local Avon, NY Manufacturer accepting applications for Safety Coordinator

Monday-Friday, 40-50 hours per week.

Bene ts include: PTO, paid recognized holidays, 401K, medical, dental, life insurance, EAP, long and short term disability

Starting Salary: $1,100/wk, negotiable based on experience & certi cations.

Minimum 5 years’ experience in comprehensive safety management. NYS DOT experience a must. Bachelor’s degree required. Apply at:

Apply in person at 495 Rochester St., Avon, NY or email: H-R@graymetal.com

Apply in person at 495 Rochester St., Avon, NY or email: H-R@graymetal.com

Local Avon, NY Manufacturer accepting applications for Full-Time A Shi

Bene ts include: $250 sign-on bonus, PTO, paid recognized holidays, 401K, medical, dental, life insurance, EAP, long and short term disability.

Positions available:

Production Workers

$15.40-$16.10/Hour

Monday – ursday 7AM-5:30PM

Loader/Pullers

$17.40/Hour

Monday – Friday 7AM-3:30PM

Local Avon, NY Manufacturer accepting applications for Maintenance Technician

• M-F 8AM – 4:30PM. A shi , overtime available.

• General manufacturing machinery maintenance.

• Minimum 5 years’ experience in maintenance.

• Eligible for PTO per company handbook.

• Paid recognized holidays.

• Eligible for medical/dental.

• Life insurance & 401K

• Must have basic tools. Uniforms provided.

• Start hourly compensation $22.25 – $23.25 based on experience plus bene ts.

• Sign-on bonus $250 at 90 day review.

Apply in person at 495 Rochester St., Avon, NY or email: H-R@graymetal.com

Apply in person at 495 Rochester St., Avon, NY or email: H-R@graymetal.com

Looking For Experienced Asphalt Crewman; Rakers, Laborers, and Class A & B Truck Drivers.

Willing to train motivated individuals. Must have reliable transportation.

Contact bandmpaving@frontiernet.net or call 585-264-0076

LABORER: EXCAVATING/PAVING

Full-Time

CDL DUMP TRUCK DRIVER

CDL B required. Full or Part-Time Small, local paving company. Call Tony: 585-748-4348 or 585-624-3778

RUSH-HENRIETTA CENTRAL SCHOOL DISTRICT FULL-TIME CLEANERS NEEDED

NEW HIRING RATE $15.00/HR PLUS SHIFT DIFFERENTIAL

• 2nd shift • Must have ability to lift 30 lbs.

• Prior cleaning experience preferred

• Includes excellent benefits

Apply online at

rhnet.org

Experience the R-H Advantage!

Class A CDL Driver With Tanker Endorsement

For transport work as well as milk truck driver. Several positions are open for motivated individuals. Competitive pay with benefits.

Please send letter of interest to rdrowcliffe@yahoo.com or call 1-716-474-1548 to schedule an interview.