Statin therapy does not appear to increase or reduce the risk for diabetic polyneuropathy (DPN) in patients with newly diagnosed type 2 diabetes, according to study results in Diabetes Care.
Statins feature anti-inflammatory and lipid-lowering effects that are believed to be helpful in reducing the risk for DPN. In spite of these proposed benefits, treatment with statins can increase neurotoxicity.
To investigate these effects, researchers from Denmark analyzed individual-level data from population-based Danish medical registries to identify Danish patients who received a new diagnosis of type 2 diabetes between 2002 and 2016. The investigators identified new users of statins who initiated lipid-lowering therapy between 180 days before and 180 days after their first diabetes record (n=59,255). They also identified prevalent users of statins, defined as patients who started statins before the defined new-user period (n=75,528).
The investigators looked for cases of incident DPN starting 180 days after patients’ first diabetes record and compared these cases between new statin users, prevalent statin users, and patients who did not use statins (n=124,842).
During the median follow-up period of 6.2 years, the incidence rate of DPN events per 1000 person-years was statistically the same among new users (4; 95% CI, 3.8-4.2), prevalent users (3.8; 95% CI, 3.6-3.9), and nonusers (3.8; 95% CI, 3.7-4).
Compared with nonusers of statins, the adjusted hazard ratio (aHR) for DPN in new users was 1.05 (95% CI, 0.98-1.11) vs 0.97 (95% CI, 0.91-1.04) for prevalent users. New users of statin therapy were at a slightly increased risk for DPN during the first year (aHR 1.31; 95% CI, 1.12-1.53), but this risk dissipated after 2 years or more of follow-up.
Limitations of this study are the observational design and the inclusion of only Danish participants, which may reduce generalizability of the findings across other populations.
In spite of these findings, the investigators of this study wrote that they cannot exclude “a small acute harmful effect” associated with statin therapy, an effect that “is largely outweighed by the substantial clinical effect of statins in cardiovascular disease prevention.”
Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.
Kristensen FP, Christensen DH, Callaghan BC, et al. Statin therapy and risk of polyneuropathy in type 2 diabetes: a Danish cohort study. Diabetes Care. 2020:dc201004.