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Statin use increases type 2 diabetes risk
Adults treated with statin therapy are at higher risk for developing type 2 diabetes vs. those not prescribed statin therapy, according to a meta-analysis of observational studies.
“Compared with [randomized controlled trials], observational studies include ... many more subjects followed for a longer time, which may result in an increased chance to detect adverse events, in particular those that may require several years to be detected, such as diabetes,” Manuela Casula, PhD, from the Centre of Epidemiology and Preventive Pharmacology at the University of Milan, and colleagues wrote. “Furthermore, the rigorous selection of subjects recruited for [a randomized controlled trial] may lead to the exclusion of individuals at higher risk for adverse events, and this may result in an underestimation of adverse events, in particular if their incidence is low.”
Casula and colleagues analyzed 20 observational studies that assessed the risk for new-onset diabetes with statin use vs. no statin use. Included studies involved at least 1,000 participants with follow-up of at least 1 year (mean follow-up time, 7.2 years), using risk estimates reported as ORs, HRs or RR; studies were conducted between 2004 and 2016 (two case-control studies; 18 cohort studies). Most studies were conducted in Europe (n = 8) and the United States (n = 7).
Using random-effects models, researchers found that statin users have a 44% increased risk for developing type 2 diabetes vs. those who did not use statins (RR = 1.44; 95% CI, 1.31-1.58). In assessing single statins, researchers found that rosuvastatin resulted in the greatest risk (RR = 1.61; 95% CI, 1.3-1.98), followed by atorvastatin (RR = 1.49; 95% CI, 1.31-1.7). Omitting individual studies did not change risk estimates.
“These observations confirm the need of a rigorous monitoring of patients taking statins, in particular prediabetic patients or patients presenting with established risk factors for diabetes,” the researchers wrote. – by Regina Schaffer
Disclosure: The researchers report no relevant financial disclosures.