Treatment with high potency statins (especially atorvastatin and simvastatin) may increase the risk of developing diabetes, suggests a paper published on bmj.com Statins are among the most widely prescribed medications for the prevention of cardiovascular events.
Although tolerated well, an association with new-onset diabetes has recently been suggested. One trial suggested a 27% increased risk of diabetes with rosuvastatin whereas another suggested patients taking pravastatin benefitted from a 30% lower risk. As there is limited data on this subject, researchers from Canada carried out a population-based study on 1.5 million residents in Ontario, Canada to examine the association between individual statin use and new-onset diabetes. Statins included in the study were: fluvastatin, lovastatin, pravastatin, simvastatin, atorvastatin and rosuvastatin. All studies used pravastatin-treated patients as the comparison group as this has been shown to have favourable effects on newly diagnosed diabetes in animal models and clinical trials. The overall risk of developing diabetes was low but this risk was increased among some patients taking statins. Between 162 and 407 patients would have to be treated with the various statins for one extra patient to develop diabetes. Patients treated with atorvastatin were found to have a 22% increased risk of newonset diabetes, rosuvastatin an 18% increased risk and simvastatin a 10% increased risk, relative to pravastatin. In contrast, patients treated with fluvastatin were at a 5% decreased risk and lovastatin a 1% decreased risk. In conclusion, the researchers said clinicians should consider risk when contemplating statin therapy. They added 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.
