Statins and the risk of diabetes: an evidence-based review


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Abstract

The present article reviews evidence about the effect of statins on the risk of developing diabetes mellitus (DM). A literature search was performed using databases of biomedical information (PubMed et al.) from1999 to 2019. The review is based on an analysis of large randomized clinical trials and observational studies, as well as several meta-analyses exploring the effect of statins on the risk of developing diabetes. Several meta-analyses of randomized clinical trials reported low (9-12%) but statistically significant risk of statin-associated incident diabetes, while a meta-analysis of observational studies showed a higher risk of about 44%. The risk of new-onset diabetes is associated with the intensity of statin therapy and relative reduction in the level of low-density lipoproteins, but representing a class-effect. The author discusses potential pathophysiological mechanisms of statin-induced diabetes mellitus including a direct and indirect effect of insulin secretion from the β-cells of the pancreatic islets and genetic factors. Despite the increased risk of diabetes with statin use in patients with cardiovascular diseases, the health benefits of their use, as seen in improved cardiovascular outcomes far outweigh any potential risk. Statin therapy in patients at high risk of diabetes requires monitoring of blood glucose levels.

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About the authors

Marina V. Leonova

Interregional Public Organization «Association of Clinical Pharmacologists of Russia»

Email: anti23@mail.ru
MD, Professor, Corr. Member of the RANS, Clinical Pharmacologist

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