Statins linked to double the risk of type 2 diabetes

Patients prescribed statins for CV risk reduction are more than twice as likely to develop type 2 diabetes compared to non-statin users, a study out of Ohio State University has found.

First author and OSU graduate student Victoria A. Zigmont and colleagues said in Diabetes/Metabolism Research and Reviews that while statins are one of the most widely prescribed medications in the U.S., they’ve also been tenuously linked to an increased risk of new-onset diabetes. Zigmont and her team sought to clarify the relationship with a large-scale prospective study of Midwestern patients enrolled in a private local insurance plan. 

The researchers considered a group of 4,683 men and women who didn’t have diabetes at the study’s baseline but were candidates for statins based on their heart disease risk. Although no participants reported taking statins before the study, 755—around 16% of the pool—were eventually prescribed the drugs during a three-year period ending in 2014.

Patients who started taking statins during the study wound up with double the risk of a diabetes diagnosis compared to their counterparts—triple the risk if they’d been taking the cholesterol-lowering drugs for more than two years. Statin users were also 6.5% more likely to have a “troublingly high” HbA1c value.

Zigmont said in a release the fact that increased duration of statin use was linked to an increased risk of diabetes suggests the relationship between statins and diabetes is a causal one.

“That said, statins are very effective in preventing heart attacks and strokes,” she said. “I would never recommend that people stop taking the statin they’ve been prescribed based on this study, but it should open up further discussions about diabetes prevention and patient and provider awareness of the issue.”

She said the research team took into account a variety of confounding factors to determine if statins were the culprit behind diabetes diagnoses, including gender, age, ethnicity, education level, cholesterol and triglyceride readings, BMI, waist circumference and number of visits to the doctor. But the study cohort was inherently limited in that most statin users were white, and the researchers had no way of knowing how closely patients adhered to their doctors’ recommendations.

“As lifestyle programs like the Diabetes Prevention Program are promoted in primary care settings, we hope physicians will integrate and insurers support healthy lifestyle strategies as part of the optimal management of individuals at risk for both new-onset diabetes and cardiovascular disease,” Zigmont and colleagues wrote in their journal article. “The relationships between statin use and glycemic control should be evaluated in large cohort studies, medical record databases and mechanistic investigations to inform clinical judgment and treatment.”