Some statins may influence the development of diabetes more than previously believed. A study found that in a large population of men on statins, a significant number developed diabetes, with risk increasing in a dose-dependent manner.
Henna Cederberg, MD, PhD, of Kuopio University Hospital in Kuopio, Finland, and colleagues used patients in the METSIM (Metabolic Syndrome in Men) study for their analysis. The cohort included 8,749 participants who were nondiabetic at baseline. Average follow-up was 5.9 years.
Almost a quarter of patients were on statins at baseline, most on simvastatin (Zocor, Merck) (65.9 percent) or atorvastatin (Lipitor, Pfizer) (18.1 percent). The researchers found that at follow-up, the number of patients on statins who developed diabetes was nearly double those who weren’t taking statins.
Statin treatment increased risk for type 2 diabetes by 46 percent. Compared with those not taking statins, patients taking simvastatin and atorvastatin had significantly increased risks for diabetes even when adjusting for confounders (hazard ratio 1.49 and 1.21, respectively). Dose also played a role. High and low doses of simvastatin bore risks of 1.44 and 1.28, respectively; high-dose atorvastatin had a risk of 1.37, after adjustment.
Other statins had some influence on development of diabetes. However, the numbers of patients on these other treatments were too few to reliably detect trends.
Much of the increase in risk for diabetes appeared to relate to how statins influenced insulin sensitivity and secretion. Insulin sensitivity decreased by 24 percent for patients taking statins. Meanwhile, insulin secretion decreased by 12 percent on statins, with dependency on dose.
“Individuals who developed diabetes on statin therapy in our study had a similar metabolic risk factor profile at baseline to those who developed diabetes without statin therapy, suggesting that statin treatment increased the risk of diabetes independently of the risk profile of the background population,” Cederberg et al wrote.
The study was published online March 4 in Diabetologia.