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Statin use and the risk of incident diabetes mellitus: a review of the literature.

Abstract

Statins are one of the most widely prescribed medications in the world. They are beneficial in both the primary and secondary prevention of atherosclerotic cardiovascular disease events. In recent years, however, concern has been raised regarding an increased incidence of new-onset diabetes mellitus observed in clinical trials of statin therapy. While most randomized, placebo controlled, statin trials have not included the incidence of new-onset diabetes as a major primary end point, a very small but consistent adverse effect on glycosylated hemoglobin and blood glucose levels, which is presently of unknown clinical significance, has been observed. Importantly, it should be remembered that some patient subgroups exposed to statin therapy, such as those with the metabolic syndrome, may already be particularly vulnerable to developing diabetes mellitus. Experimentally, although the weight of evidence suggests a protective effect of statins on the development of diabetes mellitus, basic science studies have documented conflicting evidence regarding both the beneficial and adverse effects from statin therapy on insulin secretion and sensitivity. In addition, the possibility that statin-induced muscle inflammation may elevate blood glucose levels cannot be excluded. Thus, although the biological plausibility of statins inducing diabetes certainly may exist, at the present time, sufficient high-quality scientific evidence does not exist to definitively establish the veracity or the strength of any putative cause and effect relationship. And without such evidence, there is no current impetus to alter existing clinical practice recommendations regarding the appropriate use of statin therapy.

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  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    University of Calgary, Calgary, Alberta, Canada.

    Source

    MeSH

    Diabetes Mellitus
    Disease Susceptibility
    Dose-Response Relationship, Drug
    Evidence-Based Medicine
    Female
    Humans
    Hydroxymethylglutaryl-CoA Reductase Inhibitors
    Incidence
    Male
    Prognosis
    Randomized Controlled Trials as Topic
    Risk Assessment
    Risk Management

    Pub Type(s)

    Comparative Study
    Journal Article
    Review

    Language

    eng

    PubMed ID

    22658337

    Citation

    Colbert, Jillian D., and James A. Stone. "Statin Use and the Risk of Incident Diabetes Mellitus: a Review of the Literature." The Canadian Journal of Cardiology, vol. 28, no. 5, 2012, pp. 581-9.
    Colbert JD, Stone JA. Statin use and the risk of incident diabetes mellitus: a review of the literature. Can J Cardiol. 2012;28(5):581-9.
    Colbert, J. D., & Stone, J. A. (2012). Statin use and the risk of incident diabetes mellitus: a review of the literature. The Canadian Journal of Cardiology, 28(5), pp. 581-9. doi:10.1016/j.cjca.2012.03.021.
    Colbert JD, Stone JA. Statin Use and the Risk of Incident Diabetes Mellitus: a Review of the Literature. Can J Cardiol. 2012;28(5):581-9. PubMed PMID: 22658337.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Statin use and the risk of incident diabetes mellitus: a review of the literature. AU - Colbert,Jillian D, AU - Stone,James A, Y1 - 2012/06/01/ PY - 2012/02/10/received PY - 2012/03/27/revised PY - 2012/03/27/accepted PY - 2012/6/5/entrez PY - 2012/6/5/pubmed PY - 2012/12/12/medline SP - 581 EP - 9 JF - The Canadian journal of cardiology JO - Can J Cardiol VL - 28 IS - 5 N2 - Statins are one of the most widely prescribed medications in the world. They are beneficial in both the primary and secondary prevention of atherosclerotic cardiovascular disease events. In recent years, however, concern has been raised regarding an increased incidence of new-onset diabetes mellitus observed in clinical trials of statin therapy. While most randomized, placebo controlled, statin trials have not included the incidence of new-onset diabetes as a major primary end point, a very small but consistent adverse effect on glycosylated hemoglobin and blood glucose levels, which is presently of unknown clinical significance, has been observed. Importantly, it should be remembered that some patient subgroups exposed to statin therapy, such as those with the metabolic syndrome, may already be particularly vulnerable to developing diabetes mellitus. Experimentally, although the weight of evidence suggests a protective effect of statins on the development of diabetes mellitus, basic science studies have documented conflicting evidence regarding both the beneficial and adverse effects from statin therapy on insulin secretion and sensitivity. In addition, the possibility that statin-induced muscle inflammation may elevate blood glucose levels cannot be excluded. Thus, although the biological plausibility of statins inducing diabetes certainly may exist, at the present time, sufficient high-quality scientific evidence does not exist to definitively establish the veracity or the strength of any putative cause and effect relationship. And without such evidence, there is no current impetus to alter existing clinical practice recommendations regarding the appropriate use of statin therapy. SN - 1916-7075 UR - https://www.unboundmedicine.com/medline/citation/22658337/Statin_use_and_the_risk_of_incident_diabetes_mellitus:_a_review_of_the_literature_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0828-282X(12)00181-X DB - PRIME DP - Unbound Medicine ER -