The Association of Statin Therapy with Incident Diabetes: Evidence, Mechanisms, and Recommendations

Curr Cardiol Rep. 2018 May 19;20(7):50. doi: 10.1007/s11886-018-0995-6.

Abstract

Purpose of review: Recent studies have demonstrated a higher risk of incident diabetes associated with statin use, causing concern among patients and clinicians. In this review, we will assess the evidence and proposed mechanisms behind statin therapy and its association with incident diabetes. We will then review the current recommendations for statin use in light of this association and suggest next steps for clinicians managing these patients and researchers exploring this phenomenon.

Recent findings: The annual risk of developing new-onset diabetes with statin treatment is approximately 0.1%. In comparison, the absolute risk reduction of major coronary events with statin use is approximately 0.42% annually. Statins are associated with the development of incident diabetes, particularly among those with predisposing risk factors for diabetes. However, the benefit of statin use among these patients in preventing major coronary events strongly favors statin use despite its risk of incident diabetes.

Keywords: Atherosclerotic cardiovascular disease (ASCVD); Diabetes; Low-density lipoprotein cholesterol (LDL-C); Statin.

Publication types

  • Review

MeSH terms

  • Cardiovascular Diseases / prevention & control
  • Diabetes Mellitus, Type 2 / chemically induced*
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / adverse effects*
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use
  • Risk Assessment
  • Risk Factors

Substances

  • Hydroxymethylglutaryl-CoA Reductase Inhibitors