Could statins increase Type 2 diabetes risk?

A retrospective analysis of patient records suggests a link between statins and diabetes, with the use of the common cholesterol-lowering medication potentially increasing an individual’s risk of developing new onset diabetes.

A retrospective analysis of 4683 Midwest private insurance plan patients’ health records, biometric screening data, claims data and health survey answers has found that individuals taking common cholesterol-lowering drugs – statins – were at an increased risk of developing new onset diabetes.

According to federal estimates, over 25% of middle-aged individuals take cholesterol-lowering drugs such as statins. These drugs aim to reduce patient’s blood pressure and risk of suffering adverse cardiovascular events including strokes and heart attacks.

This study, published in Diabetes Metabolism Research and Reviews, assessed 4683 patients who – based on heart disease risk assessments – were eligible for statin treatment, had never taken statins prior to study commencement and did not have diabetes.

775 of these patients were prescribed statins at some point during the 3-year study, which ran from 2011—2014.

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Compared with individuals who did not take statins, the study found that statin users were twice as likely to develop new onset diabetes. This association was use-dependent; individuals taking statins for more than 2 years were at the greatest risk of type 2 diabetes diagnosis.

To better establish the causal link between statin use and diabetes development, the study took into account various confounding factors including patient gender, age, ethnicity, education level, cholesterol and triglyceride readings, body mass index, waist circumference and the number of doctor visits.

Victoria Zigmont, lead study author from Ohio State University (OH, USA) commented: “The fact that increased duration of statin use was associated with an increased risk of diabetes – something we call a dose-dependent relationship – makes us think that this is likely a causal relationship.”

The study also found that, compared to patients not on statins, statin users were 6.5% more likely to have high (>6.0%) HbA1c readings; HbA1c blood tests evaluate the percentage of glycosylated hemoglobin and are commonly used to assess patient’s mean blood glucose measurements over the preceding few months.

“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.”

Zigmont continued that, despite these findings, “…statins are very effective in preventing heart attacks and strokes. 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.”

The results of the study highlight that whilst statins are useful and efficacious in certain patient cohorts, further research and discussion on the potential effects of statins on carbohydrate and lipid metabolism is needed.

The study authors recommend that patients being prescribed statins should be closely monitored in the following years for indicators of diabetes development and should receive specific diet and lifestyle education for diabetes prevention.

Going forward, investigations into whether different types of statins differentially impact on the risk of diabetes development is required.

Steven Clinton, a professor of medicine, member of Ohio State’s Comprehensive Cancer Center (OH, USA) and study co-author, also noted that: “In addition, researchers conducting large prospective cohort studies should be considering how statins impact human health overall. They should consider both risks and benefits, not just the disease that is being treated by the specific drug.”