Statin users have an elevated risk of dysglycemia and new‐onset‐diabetes
Victoria A. Zigmont Diabetes Metabolism Research and Reviews. 2019;35":e3189.
Objective: Statins are one of the most widely prescribed medications in the
United States; however, there is a concern that they are associated with new‐
onset‐diabetes (NOD) development. We sought to understand the risk of
dysglycemia and NOD for a cohort of individuals that reflect real‐world physician
prescribing patterns.
Methods: A retrospective cohort study was conducted among individuals with indications for statin use (n = 7064). To examine elevated glycosylated hemoglobin
(>6.0%), logistic regression with inverse probability weighting was used to create balance between incident statin users and nonusers. To evaluate the risk of NOD development, Cox PH models with time varying statin use compared NOD diagnoses among statin users and nonusers.
Results: A higher prevalence of elevated HbA1c (PD = 0.065; 95% CI: 0.002, 0.129,
P = 0.045) occurred among nondiabetic incident users of statins. Additionally, statin
users had a higher risk of developing NOD (AHR = 2.20; 95% CI: 1.35, 3.58,
P = 0.002). Those taking statins for 2 years or longer (AHR = 3.33; 95% CI: 1.84,
6.01, P < 0.001) were at the greatest risk of developing NOD; no differences were
observed by statin class or intensity of dose.
Conclusion: As lifestyle programs like the Diabetes Prevention Program are promoted in primary care settings, we hope physicians will integrate and insurers
support healthy lifestyle strategies as part of the optimal management of individuals
at risk for both NOD and cardiovascular disease. The relationships between statin
use and glycemic control should be evaluated in large cohort studies, medical
record databases, and mechanistic investigations to inform clinical judgment and
treatment.
