Statin use and risk of developing diabetes: results from the Diabetes Prevention Program

Publication Description
ObjectiveSeveral clinical trials of cardiovascular disease prevention with statins have reported increased risk of type 2 diabetes (T2DM) with statin therapy. However, participants in these studies were at relatively low risk for diabetes. Further, diabetes was often based on self-report and was not the primary outcome. It is unknown whether statins similarly modify diabetes risk in higher risk populations.Research design and methodsDuring the Diabetes Prevention Program Outcomes Study (n=3234), the long-term follow-up to a randomized clinical trial of interventions to prevent T2DM, incident diabetes was assessed by annual 75 g oral glucose tolerance testing and semiannual fasting glucose. Lipid profile was measured annually, with statin treatment determined by a participant’s own physician outside of the protocol. Statin use was assessed at baseline and semiannual visits.ResultsAt 10 years, the cumulative incidence of statin initiation prior to diabetes diagnosis was 33%–37% among the randomized treatment groups (p=0.36). Statin use was associated with greater diabetes risk irrespective of treatment group, with pooled HR (95% CI) for incident diabetes of 1.36 (1.17 to 1.58). This risk was not materially altered by adjustment for baseline diabetes risk factors and potential confounders related to indications for statin therapy.ConclusionsIn this population at high risk for diabetes, we observed significantly higher rates of diabetes with statin therapy in all three treatment groups. Confounding by indication for statin use does not appear to explain this relationship. The effect of statins to increase diabetes risk appears to extend to populations at high risk for diabetes.Trial registration numberNCT00038727; Results.

Primary Author
Crandall,Jill P.
Mather,Kieren
Rajpathak,Swapnil N.
Goldberg,Ronald B.
Watson,Karol
Foo,Sandra
Ratner,Robert
Barrett-Connor,Elizabeth
Temprosa,Marinella

Volume
5

Issue
1

Other Pages
e000438

Publisher
BMJ Publishing Group LTD

URL
http://dx.doi.org/10.1136/bmjdrc-2017-000438

PMID
29081977



Reference Type
Journal Article

Periodical Full
BMJ Open Diabetes Research & Care

Publication Year
2017

Publication Date
Oct

Place of Publication
England

ISSN/ISBN
2052-4897

Document Object Index
10.1136/bmjdrc-2017-000438