Wednesday, May 8, 2013

Are Statins Worth the Diabetes Risk?

Among the patients with 0-1 risk factors at baseline, diabetes developed in 142 of 4407 patients in the high-statin-dose group and in 148 of 4418 patients in the low-dose groups. Meanwhile, CV events were significantly lower in the high-dose group. Among the patients with 2-4 risk factors, diabetes developed in 448 of 3128 patients in the high-dose group and in 368 of 3103 patients in the lower-dose groups. However, the risk for CV events was 18% lower in the high-dose group.

Recent studies indicating an increased incidence of diabetes associated with statins have raised concerns on 2 fronts. First, some may worry that the hyperglycemic effect of statins may put individuals at risk of developing a serious chronic disease. Indeed, a meta-analysis of previous studies found a 9% increased risk for diabetes associated with statin use.[1]

Furthermore, there appears to be a dose response with greater risk for diabetes among patients who are treated intensively with statins compared with placebo or moderate statin doses.[2,3] However, few would argue that statins provide substantial cardioprotection; therefore, a second concern is that the relatively low risk of developing diabetes might cause some patients to avoid statin therapy despite being at high risk for cardiovascular events.