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Study Finds Statins Increase Diabetes Risk by 46%

Risk is dose-dependent for simvastatin and atorvastatin

New research published in Diabetologia, the journal of the European Association for the Study of Diabetes, shows that the use of statins is associated with a 46% increase in the risk of developing diabetes, even after adjustments for confounding factors. The study was conducted in Finland.

Previous research has suggested that an increased risk of developing diabetes is associated with statin use. However, statin trials have included participants with a high risk of cardiovascular disease. Therefore, the authors of the new study say, the risk of diabetes in clinical trials is likely to differ from that in the general population. In previous studies, the diagnosis of diabetes was based on self-reported diabetes or fasting glucose measurements, leading to an underestimation of the actual numbers of incident diabetes cases.

In the new investigation, the authors looked at the effects of statin treatment on the risk of type-2 diabetes and on the deterioration of blood sugar control in 8,749 nondiabetic Caucasian men in a 6-year follow-up of the population-based Metabolic Syndrome in Men (METSIM) study, based in Kuopio, Finland. The authors also investigated the mechanisms of statin-induced diabetes by evaluating changes in insulin resistance and insulin secretion.

The participants, aged 45 to 73 years, were followed for 5.9 years. New diabetes was diagnosed in 625 men with either an oral glucose tolerance test,, a hemoglogin A1c level of 6.5% or higher, or antidiabetic medication started during the follow-up period, and insulin sensitivity and secretion were evaluated.

The researchers found that, after the results were adjusted for age, the body mass index (BMI), the waist circumference, physical activity, smoking, alcohol intake, a family history of diabetes, and beta-blocker and diuretic treatment, patients receiving statins were 46% more likely to develop diabetes than were those not treated with statins.

This risk was dose-dependent for simvastatin and atorvastatin. Statin treatment significantly increased 2-h glucose (2hPG) at follow-up, with a nominally significant increase in fasting plasma glucose. Insulin sensitivity was reduced by 24% and insulin secretion by 12% in individuals receiving statin treatment.

Further, decreases in insulin sensitivity and insulin secretion were dose-dependent for simvastatin and atorvastatin. After adjustments for all of the confounding factors mentioned above, high-dose simvastatin was associated with a 44% increased risk of developing diabetes, whereas the risk was increased by 28% for low-dose simvastatin and by 37% for high-dose atorvastatin. Overall, 29% of the participants received simvastatin and 53% received atorvastatin.

“The association of statin use with an increased risk of developing diabetes is most likely directly related to statins decreasing both insulin sensitivity and secretion,” the authors observed.

Further, they emphasized that while the size of the study makes their conclusions reliable, the study sample consisted entirely of Caucasian men; therefore, the applicability of the findings to women or to people of other ethnic origins cannot be confirmed without further research.

The authors concluded: “Statin therapy was associated with a 46% increased risk of type 2 diabetes after adjustment for confounding factors, suggesting a higher risk of diabetes in the general population than previously reported.”

Sources: Medical Xpress; April 15, 2015; and Diabetologia; March 10, 2015.

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