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Use of Statins and the Risk of Incident Diabetes: A Retrospective Cohort Study.
Am J Cardiovasc Drugs 2016; 16(5):377-90AJ

Abstract

INTRODUCTION

Even though several landmark statin trials have demonstrated the beneficial effects of statin therapy in both primary and secondary prevention of cardiovascular disease, several studies have suggested that statins are associated with a moderate increase in risk of new-onset diabetes. These observations prompted the US FDA to revise statin labels to include a warning of an increased risk of incident diabetes mellitus as a result of increases in glycosylated hemoglobin (HbA1c) and fasting plasma glucose. However, few studies have used US-based data to investigate this statin-associated increased risk of diabetes.

OBJECTIVE

The primary objective of our study was to examine whether the use of statins increases the risk of incident diabetes mellitus using data from the Thomson Reuters MarketScan (®) Commercial Claims and Encounters Database.

METHOD

This study was a retrospective cohort analysis utilizing data for the period 2003-2004. The study population included new statin users aged 20-63 years at index who did not have a history of diabetes.

RESULTS

The proportion (3.4 %) of statin users (N = 53,212) who had incident diabetes was higher than the proportion (1.2 %) of non-statin users (N = 53,212) who had incident diabetes. Compared with no statin use and controlling for demographic and clinical covariates, statin use was significantly associated with increased risk of incident diabetes (hazard ratio 2.01; 99 % confidence interval 1.74-2.33; p < 0.0001). In addition, risk of diabetes was highest among users of lovastatin, atorvastatin, simvastatin, and fluvastatin. Diabetes risk was lowest among pravastatin and rosuvastatin users.

DISCUSSION

Because the potential for diabetogenicity differs among different statin types, healthcare professionals should individualize statin therapy by identifying patients who would benefit more from less diabetogenic statin types.

Authors+Show Affiliations

Department of Pharmacy Practice, University of Kansas School of Pharmacy, 2010 Becker Dr., Lawrence, KS, 66047, USA. buzzlotus@ku.edu. Division of Health Outcomes and Pharmacy Practice, College of Pharmacy, The University of Texas at Austin, 2409 University Avenue A1930, Austin, TX, 78712-1120, USA. buzzlotus@ku.edu. Austin Outcomes Research, 1600 Flintridge Rd, West Lake Hills, TX, 78746, USA. buzzlotus@ku.edu.Division of Health Outcomes and Pharmacy Practice, College of Pharmacy, The University of Texas at Austin, 2409 University Avenue A1930, Austin, TX, 78712-1120, USA.Division of Health Outcomes and Pharmacy Practice, College of Pharmacy, The University of Texas at Austin, 2409 University Avenue A1930, Austin, TX, 78712-1120, USA. Austin Outcomes Research, 1600 Flintridge Rd, West Lake Hills, TX, 78746, USA.Division of Health Outcomes and Pharmacy Practice, College of Pharmacy, The University of Texas at Austin, 2409 University Avenue A1930, Austin, TX, 78712-1120, USA.Division of Health Outcomes and Pharmacy Practice, College of Pharmacy, The University of Texas at Austin, 2409 University Avenue A1930, Austin, TX, 78712-1120, USA.Division of Health Outcomes and Pharmacy Practice, College of Pharmacy, The University of Texas at Austin, 2409 University Avenue A1930, Austin, TX, 78712-1120, USA.Department of Pharmacy Practice, University of Kansas School of Pharmacy, 2010 Becker Dr., Lawrence, KS, 66047, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27272032

Citation

Olotu, Busuyi S., et al. "Use of Statins and the Risk of Incident Diabetes: a Retrospective Cohort Study." American Journal of Cardiovascular Drugs : Drugs, Devices, and Other Interventions, vol. 16, no. 5, 2016, pp. 377-90.
Olotu BS, Shepherd MD, Novak S, et al. Use of Statins and the Risk of Incident Diabetes: A Retrospective Cohort Study. Am J Cardiovasc Drugs. 2016;16(5):377-90.
Olotu, B. S., Shepherd, M. D., Novak, S., Lawson, K. A., Wilson, J. P., Richards, K. M., & Rasu, R. S. (2016). Use of Statins and the Risk of Incident Diabetes: A Retrospective Cohort Study. American Journal of Cardiovascular Drugs : Drugs, Devices, and Other Interventions, 16(5), pp. 377-90. doi:10.1007/s40256-016-0176-1.
Olotu BS, et al. Use of Statins and the Risk of Incident Diabetes: a Retrospective Cohort Study. Am J Cardiovasc Drugs. 2016;16(5):377-90. PubMed PMID: 27272032.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Use of Statins and the Risk of Incident Diabetes: A Retrospective Cohort Study. AU - Olotu,Busuyi S, AU - Shepherd,Marvin D, AU - Novak,Suzanne, AU - Lawson,Kenneth A, AU - Wilson,James P, AU - Richards,Kristin M, AU - Rasu,Rafia S, PY - 2016/6/9/entrez PY - 2016/6/9/pubmed PY - 2017/1/18/medline SP - 377 EP - 90 JF - American journal of cardiovascular drugs : drugs, devices, and other interventions JO - Am J Cardiovasc Drugs VL - 16 IS - 5 N2 - INTRODUCTION: Even though several landmark statin trials have demonstrated the beneficial effects of statin therapy in both primary and secondary prevention of cardiovascular disease, several studies have suggested that statins are associated with a moderate increase in risk of new-onset diabetes. These observations prompted the US FDA to revise statin labels to include a warning of an increased risk of incident diabetes mellitus as a result of increases in glycosylated hemoglobin (HbA1c) and fasting plasma glucose. However, few studies have used US-based data to investigate this statin-associated increased risk of diabetes. OBJECTIVE: The primary objective of our study was to examine whether the use of statins increases the risk of incident diabetes mellitus using data from the Thomson Reuters MarketScan (®) Commercial Claims and Encounters Database. METHOD: This study was a retrospective cohort analysis utilizing data for the period 2003-2004. The study population included new statin users aged 20-63 years at index who did not have a history of diabetes. RESULTS: The proportion (3.4 %) of statin users (N = 53,212) who had incident diabetes was higher than the proportion (1.2 %) of non-statin users (N = 53,212) who had incident diabetes. Compared with no statin use and controlling for demographic and clinical covariates, statin use was significantly associated with increased risk of incident diabetes (hazard ratio 2.01; 99 % confidence interval 1.74-2.33; p < 0.0001). In addition, risk of diabetes was highest among users of lovastatin, atorvastatin, simvastatin, and fluvastatin. Diabetes risk was lowest among pravastatin and rosuvastatin users. DISCUSSION: Because the potential for diabetogenicity differs among different statin types, healthcare professionals should individualize statin therapy by identifying patients who would benefit more from less diabetogenic statin types. SN - 1179-187X UR - https://www.unboundmedicine.com/medline/citation/27272032/Use_of_Statins_and_the_Risk_of_Incident_Diabetes:_A_Retrospective_Cohort_Study_ L2 - https://dx.doi.org/10.1007/s40256-016-0176-1 DB - PRIME DP - Unbound Medicine ER -