Statins and the risk of new-onset diabetes

Abstract

Statins are the most prescribed medications worldwide with a proven ability to reduce major cardiovascular events. Recent data have revealed that statin therapy is associated with an increased risk for developing diabetes. We discuss the relevant data including newly published results, which demonstrate a dose-dependent association, we place these findings in clinical context and we consider clinical implications. A recent meta-analysis of most major placebo and standard care-controlled statin trials with more than 90,000 participants confirmed that statin therapy was associated with a 9% increased risk of developing diabetes. Newly published data have confirmed a dose-dependent effect, with 12% higher risk of developing diabetes on intensive-dose statin therapy compared with moderate-dose therapy. In this meta-analysis, one additional patient developed diabetes for every three patients protected from a major cardiovascular event. The observation of higher diabetes risk remains unexplained at present, although studies in animal models suggest the possibility of impaired peripheral insulin signalling induced by statin therapy. The cardiovascular benefits of statin therapy clearly outweigh the risk of developing diabetes. However, the data suggest the need to make patients aware of this possible risk and to monitor patients for development of diabetes, especially on intensive-dose therapy.