High-intensity statins are linked to hypoglycemia during hospitalization

  • Khanimov I & al.
  • Am J Med
  • 21 Jun 2019

  • International Clinical Digest
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Takeaway

  • Among internal medicine unit inpatients, statin treatment overall is associated with reduced hypoglycemia.
  • For those with low admission serum albumin, however, high-intensity statins are associated with increased hypoglycemia (

Why this matters

  • Inpatient hypoglycemia is linked to decreased 1-year survival.

Study design

  • Retrospective study of 31,094 patients discharged from internal medicine wards, 2010-2013.
  • Funding: None.

Key results

  • Compared with 6.7% of patients overall and 6.5% of all statin-treated patients experiencing ≥1 documented inpatient hypoglycemia event, overall rates among those with diabetes and those with low (
  • Hypoglycemia rates with:
    • Low-intensity statins: 5.0%;
    • Moderate-intensity statins: 6.7%; and
    • High-intensity statins: 6.4%.
  • Among patients with low albumin, high- vs low-intensity statins were associated with higher hypoglycemia incidence:
    • Significantly so without diabetes: 9.3% vs 4.8% (P<.05>
    • Trending to significance with diabetes: 25.2% vs 17.7% (P=.087).
    • No such relationship was seen with albumin >3.5 g/dL.
  • 1-year mortality with albumin >3.5 g/dL and:
    • Low-intensity statins: 2.0%;
    • Moderate-intensity statins: 2.1%; 
    • High-intensity statins: 2.4%; and
    • No statins: 3.4%.  
  • 1-year mortality with albumin
  • Low-intensity statins: 13.9%;
  • Moderate-intensity statins: 18.3%; 
  • High-intensity statins: 19.3%; and
  • No statins: 33.8%.

Limitations

  • Retrospective.