Statins raise risk for insulin resistance and T2D

  • Ahmadizar F & al.
  • Br J Clin Pharmacol
  • 5 Mar 2019

  • International Clinical Digest
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Takeaway

  • Statin treatment raises the risk for hyperglycemia, insulin resistance, and type 2 diabetes (T2D).
  • Aggressive glucose control and weight reduction at statin initiation may minimize risks.

Why this matters

  • Previous studies finding increased T2D risk with statins have lacked details.

Study design

  • Prospective, population-based study, 9535 people ages >45 years without diabetes at baseline followed for median 4 (up to 15) years; 10% were statin users.
  • Funding: None disclosed.

Key results

  • During follow-up, 716 developed T2D.
  • Statin users had a 38% higher risk for incident T2D:
    • HR, 1.38 (95% CI, 1.09-1.74).
  • With full adjustment for potential confounders, vs never-users, statin users had significantly higher:
    • serum fasting insulin (β, 0.07; 95% CI, 0.02-0.13), and
    • insulin resistance (0.09; 0.03-0.14).  
  • T2D risk was significant among current but not past statin users:
    • HRs: 1.52 (95% CI, 1.15-2.00) vs 1.18 (0.83-1.67).
  • Among statin users, no relationship seen between statin type or dose and T2D risk.
  • In sensitivity analyses, association was statistically significant: 
    • in men (HR, 1.52; 95% CI, 1.07-2.16), 
      • but not women (1.28; 0.93-1.74); 
    • with overweight/obesity (1.42; 1.10-1.83), 
      • but not normal BMI (1.18; 0.69-2.02).

Limitations

  • No HbA1c data.
  • Possible reverse causality.
  • Possible residual confounding, detection bias.
  • Population 95% white.

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