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Atorvastatin and simvastatin ‘increase the risk of type 2 diabetes by 46%’

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The study

Approximately 8,700 non-diabetic patients were followed up for almost 6 years, and approximately 2,100 of these patients were put on statins. Insulin secretion and sensitivity were assessed using OGTT-derived indices. (Previous research has shown that pravastatin increases insulin sensitivity and reduces the risk of getting diabetes.)

Main findings

1 For atorvastatin and simvastatin, the risk of getting diabetes was dose-dependent

2 There was no increase in risk of diabetes with the other statins: pravastatin, fluvastatin, and lovastatin. However, the number of patients taking the other statins was not sufficient to assess how the effect that these drugs individually had on the risk of diabetes.

3 Overall the patients on statins had a 46% higher risk of being diagnosed with type 2 diabetes.

4 Overall in the patients on statins, insulin secretion was reduced by 12% and insulin sensitivity was reduced by 24%.

What does this mean for GPs

GPs should be aware of the potential adverse effects of statins on insulin secretion and sensitivity, and the increased risk of diabetes.

We should be judicious in prescribing these drugs, and ensure that patients are fully aware of both risks and benefits of taking statins.

The paper

Diabetologia, May 2015

Dr Hamed Khan is a GP in the emergency department of St George’s, London and a clinical lecturer. He tweets as @drhamedkhan

Readers' comments (6)

  • Oh no not another Diclofenac nonsense. The headline is a 46% increase. That sounds a lot. The facts are an absolute risk of 1% as a baseline. So the RISK (not definite then) increases from 1% to just over 1%. This increased risk can probably be totally mitigated by other lifestyle measures.

    Lets please have some reality injected into the attention grabbing headlines. Sensationalist headlines like this caused havoc for thousands of patients on Diclofenac and other drugs in the recent past. So lets not have a knee jerk reaction to a sensationalist headline but a calm examination of the science.
    Regards
    Paul Cundy

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  • what he said ^^.
    printing the relative risk alone can be misleading this is what the daily mail does absolute risks etc please. this artice offers too little detail to draw conclusions and if waht paul cundy says is true is misleading

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  • Not sure what this study adds. Aren't those prescribed statins at a high risk of developing diabetes anyway due to them having multiple CVD risk factors?

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  • As far as I am aware statins at higher doses reduce risk relatively little compared to lower doses but have much worse side effects such as cataract, myalgia etc. Lower doses please.

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  • So people on higher doses of statins are slightly more like in absolute terms to develop diabetes than those not on statins.....isn't this what one would expect?

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  • Samuel Lewis

    This non-randomised observational follow-up of patients with 'metabolic syndrome' shows a an increase in risk of diabetes, with a major risk of selection bias.

    if you want to know the true risk of harms from Statins you should look at RCTs.

    In pooled data from 13 RCTs statin therapy was associated with a 9% increased risk of diabetes
    and this effect was age and dose dependent. Compare this with a 25% reduction in heart attacks, and a 20% reduction in all deaths.

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