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Statin-associated incident diabetes: a literature review.

Abstract

OBJECTIVE

To evaluate available evidence for incident diabetes associated with statin use and offer some practical management considerations.

DATA SOURCES

A literature search was performed using MEDLINE from 2000 to October 2013. The following MESH terms and text key words alone or in combination were included: 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors, HMG-CoA reductase inhibitors, statins, incident diabetes, new-onset diabetes, insulin resistance, impaired insulin secretion, meta-analysis, cohort study, and observational study.

STUDY SELECTION

Analyzed studies were published in English and investigated incident diabetes associated with statin use.

DATA EXTRACTION

Author consensus determined study inclusion in this review, focusing on observational studies and meta-analyses.

DATA SYNTHESIS

Since the report of incident diabetes associated with rosuvastatin, an unexpected finding in the Justification for the Use of Statins in Prevention: an Intervention Trial Evaluating Rosuvastatin, safety concerns with statins have emerged. Results of observational studies and meta-analyses show association of incident diabetes with statin use in patients with concomitant risk factors for diabetes. A pharmacodynamic mechanism has yet to be delineated, and individual statins may behave differently. Whether cardiovascular (CV) risk will increase with statin-associated incident diabetes remains unclear.

CONCLUSION

Review of current, available clinical data suggest a possible association between statin use and incident diabetes in patients with underlying diabetes risk factors. Although study data may be insufficient to change the current practice paradigm, clinicians should vigilantly monitor for incident diabetes in patients on statins. Patients with a low risk of CV disease and high risk of diabetes should reconsider statin use and focus on lifestyle management.

Links

Authors+Show Affiliations

,

Department of Pharmacy Services, Swedish Covenant Hospital, Chicago, Illinois.

,

Swedish Covenant Hospital.

,

Swedish Covenant Hospital.

Pharmacy Services and Clinical Research, Swedish Covenant Hospital.

Source

MeSH

Cardiovascular Diseases
Diabetes Mellitus
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors

Pub Type(s)

Journal Article
Meta-Analysis
Review

Language

eng

PubMed ID

24849689

Citation

Park, Zoon H., et al. "Statin-associated Incident Diabetes: a Literature Review." The Consultant Pharmacist : the Journal of the American Society of Consultant Pharmacists, vol. 29, no. 5, 2014, pp. 317-34.
Park ZH, Juska A, Dyakov D, et al. Statin-associated incident diabetes: a literature review. Consult Pharm. 2014;29(5):317-34.
Park, Z. H., Juska, A., Dyakov, D., & Patel, R. V. (2014). Statin-associated incident diabetes: a literature review. The Consultant Pharmacist : the Journal of the American Society of Consultant Pharmacists, 29(5), pp. 317-34. doi:10.4140/TCP.n.2014.317.
Park ZH, et al. Statin-associated Incident Diabetes: a Literature Review. Consult Pharm. 2014;29(5):317-34. PubMed PMID: 24849689.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Statin-associated incident diabetes: a literature review. AU - Park,Zoon H, AU - Juska,Alicia, AU - Dyakov,Detelin, AU - Patel,Ramesh V, PY - 2014/5/23/entrez PY - 2014/5/23/pubmed PY - 2015/3/3/medline KW - 3-Hydroxy-3-methylglutaryl coenzyme A reductase inhibitors KW - BMI = Body mass index KW - CHIBA = Collaborative Study on Hypercholesterolemia Drug Intervention and their Benefits for Atherosclerosis Prevention KW - CI = Confidence interval KW - CORONA = Controlled Rosuvastatin Multinational Trial in Heart Failure KW - CV = Cardiovascular KW - CVD = Cardiovascular disease KW - CrI = Credible interval KW - DM = Diabetes mellitus KW - Elderly KW - FCH = Familial combined hyperlipidemia KW - FPG = Fasting plasma glucose KW - GLUT1 = Glucose transporter type 1 KW - GLUT4 = Glucose transporter type 4 KW - HMG-CoA = 3-Hydroxyl-3-methylglutaryl coenzyme A KW - HMG-CoA reductase inhibitors KW - HOMA = Homeostasis model assessment KW - HOMA-IR = Homeostasis model assessmentinsulin resistance KW - HR = Hazard ratio KW - HbA1C = Glycosylated hemoglobin KW - IGT = Impaired glucose tolerance KW - ISG = Insulin-secreting granules KW - Incident diabetes KW - JUPITER = Justification for the Use of Statins in Prevention: an Intervention Trial Evaluating Rosuvastatin KW - LDL = Low-density lipoprotein KW - MESH = Medical subject headings KW - MI = Myocardial infarction KW - NNH = Number needed to harm KW - NNT = Number needed to treat KW - NS = Not significant KW - New-onset diabetes KW - ODB = Ontario Drug Benefit Database of Canada KW - OMID = Ontario Myocardial Infarction Database of Canada KW - OR = Odds ratio KW - PROSPER = Prospective Study of Pravastatin in the Elderly at Risk KW - QUICKI = Quantitative Insulin Check Index KW - RR = Relative risk KW - STELLAR = Statin Therapies for Elevated Lipid Levels Compared Across Doses to Rosuvastatin KW - Statins KW - WHI = Women's Health Initiative KW - WOSCOPS = West of Scotland Coronary Prevention Study SP - 317 EP - 34 JF - The Consultant pharmacist : the journal of the American Society of Consultant Pharmacists JO - Consult Pharm VL - 29 IS - 5 N2 - OBJECTIVE: To evaluate available evidence for incident diabetes associated with statin use and offer some practical management considerations. DATA SOURCES: A literature search was performed using MEDLINE from 2000 to October 2013. The following MESH terms and text key words alone or in combination were included: 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors, HMG-CoA reductase inhibitors, statins, incident diabetes, new-onset diabetes, insulin resistance, impaired insulin secretion, meta-analysis, cohort study, and observational study. STUDY SELECTION: Analyzed studies were published in English and investigated incident diabetes associated with statin use. DATA EXTRACTION: Author consensus determined study inclusion in this review, focusing on observational studies and meta-analyses. DATA SYNTHESIS: Since the report of incident diabetes associated with rosuvastatin, an unexpected finding in the Justification for the Use of Statins in Prevention: an Intervention Trial Evaluating Rosuvastatin, safety concerns with statins have emerged. Results of observational studies and meta-analyses show association of incident diabetes with statin use in patients with concomitant risk factors for diabetes. A pharmacodynamic mechanism has yet to be delineated, and individual statins may behave differently. Whether cardiovascular (CV) risk will increase with statin-associated incident diabetes remains unclear. CONCLUSION: Review of current, available clinical data suggest a possible association between statin use and incident diabetes in patients with underlying diabetes risk factors. Although study data may be insufficient to change the current practice paradigm, clinicians should vigilantly monitor for incident diabetes in patients on statins. Patients with a low risk of CV disease and high risk of diabetes should reconsider statin use and focus on lifestyle management. SN - 2331-0936 UR - https://www.unboundmedicine.com/medline/citation/24849689/Statin_associated_incident_diabetes:_a_literature_review_ L2 - http://www.diseaseinfosearch.org/result/2236 DB - PRIME DP - Unbound Medicine ER -