November 19, 2015
Allan S. Brett, MD reviewing Mansi I et al. J Gen Intern Med 2015 Nov.
In a cohort study of relatively healthy people, diabetes developed in 31% of statin users and in 19% of nonusers.
Much of the data on the association between statin therapy and new-onset diabetes has been generated from high-risk populations.
In this retrospective cohort study, researchers examined this association in a relatively healthy population of patients enrolled in the Tricare healthcare program for U.S. military families.
The researchers compared 3351 nondiabetic statin users and 3351 nonusers with no history of cardiovascular, pulmonary, renal, rheumatologic, or psychiatric disorders. Patients in these two groups were matched closely on numerous demographic and clinical variables through propensity-scoring. During a 7-year follow-up, the proportion of patients who developed diabetes was significantly higher among statin users than nonusers (30.9% vs. 19.4%). Users of high-intensity statins were more likely to develop diabetes than were users of moderate- or low-intensity statins.
Comment
The magnitude of reported excess risk for diabetes among statin users has varied considerably, depending on study methodology (randomized trial vs. cohort study), duration of statin use, and characteristics of the studied populations. However,
this finding seems to be consistent and should be considered in decision-making about statin use, especially in primary-prevention populations. But
an important issue that hasn't been discussed widely and, to my knowledge, hasn't been investigated adequately is whether statin-related diabetes is reversible when the statin is stopped.
Editor Disclosures at Time of Publication
Disclosures for Allan S. Brett, MD at time of publication Nothing to disclose
Citation(s):
Mansi I et al.
Statins and new-onset diabetes mellitus and diabetic complications: A retrospective cohort study of US healthy adults. J Gen Intern Med 2015 Nov; 30:1599. (Δεν είναι ορατοί οι σύνδεσμοι (links).
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