Overweight or obese patients have an increased risk for diabetes following the initiation of statin therapy, according to a study published in BMJ Open Diabetes Research & Care.
This study examined patients included in the Diabetes Prevention Program Outcomes Study (ClinicalTrials.gov Identifier: NCT00038727) to determine the association between statin therapy and diabetes risk among overweight or obese patients at high risk for diabetes. Participants were randomly assigned to receive either metformin (n=1073), lifestyle intervention (n=1079), or placebo (n=1082).
Regardless of treatment, patients taking statin therapy had an increased risk for diabetes. The pooled hazard ratio for incident diabetes risk was 1.36 (95% CI, 1.17-1.58), whereas hazard ratios for placebo, metformin, and lifestyle intervention were 1.33 (1.02-1.73), 1.59 (1.21-2.10), and 1.21 (0.93-1.57), respectively (P =.36).
Adjustment for diabetes risk factors at baseline or possible confounders associated with statin indications resulted in no significant modification to diabetes risk.
The original analysis failed to randomize statin therapy in patients at risk for cardiovascular disease, representing an important limitation of the study findings. Additionally, the investigators relied on self-reported data to determine patients’ statin use, potentially resulting in misclassification.
Although there were no differences in diabetes risk among the 3 randomly assigned treatment groups, the investigators reinforce the importance of monitoring glucose status as well as healthy lifestyle behaviors in high-risk patients taking statins for cardiovascular disease prevention.
“For individual patients, a potential modest increase in diabetes risk clearly needs to be balanced against the consistent and highly significant reductions in myocardial infarction, stroke, and cardiovascular death associated with statin treatment,” the study authors recommended.
Crandall JP, Mather K, Rajpathak SN, et al. Statin use and risk of developing diabetes: results from the Diabetes Prevention Program. BMJ Open Diabetes Res Care. 2017;5(1):e000438.