From the Guidelines
Statins can increase the risk of developing type 2 diabetes, but the effect is modest and the benefits of statin therapy in preventing heart attacks and strokes substantially outweigh the small increased risk of developing diabetes. According to the most recent and highest quality study, a meta-analysis of 13 randomized statin trials with 91,140 participants showed an odds ratio of 1.09 for a new diagnosis of diabetes, so that (on average) treatment of 255 patients with statins for 4 years resulted in one additional case of diabetes while simultaneously preventing 5.4 vascular events among those 255 patients 1. This suggests that the benefits of statin therapy far outweigh the risks, even for patients at highest risk for diabetes.
Key Points to Consider
- The risk of developing type 2 diabetes with statin use is dose-dependent, with higher doses of more potent statins carrying greater risk than moderate-intensity statins 1.
- Individuals with pre-existing risk factors for diabetes, such as obesity, elevated fasting glucose, or metabolic syndrome, are at higher risk of developing diabetes with statin use 1.
- Healthcare providers should monitor blood glucose levels in patients on statins, especially those with pre-existing risk factors for diabetes 1.
- The decision to use statins should always involve weighing individual cardiovascular benefits against potential risks, including the small increased risk of diabetes 1.
Clinical Implications
- Statin therapy should not be withheld from patients with established cardiovascular disease or high cardiovascular risk due to concerns about diabetes risk 1.
- Patients on statins should be monitored for signs and symptoms of diabetes, and diabetes screening should be considered for those with risk factors 1.
- The benefits of statin therapy in preventing heart attacks and strokes should be weighed against the small increased risk of developing diabetes, and individualized treatment decisions should be made based on patient-specific factors 1.
From the FDA Drug Label
Increases in HbA1c and fasting serum glucose levels have been reported with statins, including atorvastatin. Increases in HbA1c and fasting serum glucose levels have been reported with statins, including rosuvastatin. Based on clinical trial data with rosuvastatin, in some instances these increases may exceed the threshold for the diagnosis of diabetes mellitus.
Statins and Diabetes Risk: Statins, including atorvastatin and rosuvastatin, have been associated with increases in HbA1c and fasting serum glucose levels. In some cases, these increases may be significant enough to exceed the threshold for a diagnosis of diabetes mellitus.
- Key Points:
From the Research
Statins and Diabetes Risk
- The relationship between statins and diabetes risk has been extensively studied, with some research suggesting a link between the two [ 4 , 5 , 6 ].
- Studies have shown that statins may increase the risk of developing type 2 diabetes, particularly in individuals who are already at risk [ 4 , 5 ].
- The mechanisms behind this potential link are not fully understood, but may involve increased insulin resistance, impaired insulin secretion, or other effects on glucose metabolism [ 5 , 6 ].
Clinical Implications
- Despite the potential link between statins and diabetes risk, the benefits of statin therapy in reducing cardiovascular risk are generally considered to outweigh the potential risks [ 4 , 7 , 8 ].
- Clinicians should carefully assess the risk-benefit profile of statin therapy for each patient, taking into account their individual risk factors for diabetes and cardiovascular disease [ 4 , 8 ].
- Further research is needed to fully understand the relationship between statins and diabetes risk, and to determine the best strategies for mitigating any potential risks [ 4 , 6 ].