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Statin use link to diabetes
24th May 2013 - Some patients treated with high potency statins may have more than a 20% increased risk of developing diabetes, according to a new study.
However, experts point out that the overall benefit of taking statins still outweighs any potential risks.
Statins are amongst the most widely prescribed medications. They are used to lower rates of low-density lipoprotein (LDL) cholesterol - the so-called 'bad cholesterol' in the blood. In turn, this can help cut the risk of heart attack, heart disease and stroke.
Concerns have previously been raised that some statins might raise the risk of developing type 2 diabetes, so researchers in Toronto, Canada set out to assess this risk.
They used a database of 471,250 Canadians over the age of 65 with no history of diabetes who had recently been prescribed statins. The average age of those involved when they started treatment was 73.
Patients were on several types of medication: more than half were taking atorvastatin, with the remainder on rosuvastatin, simvastatin, pravastatin, lovastatin and fluvastatin.
The researchers found that patients treated with atorvastatin, rosuvastatin, or simvastatin were at increased risk of new onset diabetes compared with those treated withpravastatin. No such risk was found among those on fluvastatin or lovastatin.
Overall, there was an increased risk of between 10% and 22% of diabetes for some statins, which the authors say is consistent with previous studies and trials. For instance, patients treated with atorvastatin were found to have a 22% increased risk of new-onset diabetes, rosuvastatin an 18% increased risk and simvastatin a 10% increased risk, relative to pravastatin, which was used for comparison purposes.
In conclusion, the researchers say clinicians should consider risk when contemplating statin therapy. They write that "preferential use of pravastatin, and potentially fluvastatin ... may be warranted" and that pravastatin may even be beneficial to patients at high risk of diabetes.
The study is published on bmj.com.
Benefits versus risks
Experts say that the findings need to be taken in context, particularly when weighing up the benefits of certain medications together with their risks.
In an editorial in the same publication, doctors from the University of Turku in Finland write that "the overall benefit of statins still clearly outweighs the potential risk of incident diabetes". They conclude that as statins have been shown to reduce cardiovascular events in patients, they "play an important role in treatment".
Dr Matthew Hobbs, head of research at Diabetes UK, says in a statement: "Statins help reduce the risk of heart disease and stroke and, for many people at high risk they play an important role in preventing these potentially fatal health conditions. Previous research suggests they might also cause a slight increase in the risk of developing type 2 diabetes, but the benefit would outweigh the risk for people prescribed statins.