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Higher potency statins increase risk of diabetes

Higher potency statin use is associated with a moderate increase in the risk of new-onset diabetes compared with lower potency statins, suggests a recent study.

The study included eight population-based cohort studies and a meta-analysis, and included 136,966 patients over the age of 40 who were newly-treated with statins over a 14-year period. Patients were newly treated with statins following hospitalisation for a major cardiovascular event, and had no prior diagnosis of diabetes. Within these patient cohorts, a case-control analysis comparing incidence of diabetes in users of high potency statins with incidence in users of low potency statins was conducted.

Rate ratios of new diabetes events were estimated on different lengths of exposure to higher potency versus lower potency statins. Rosuvastatin at 10mg or more, atorvastatin at 20mg or more and simvastatin at 40mg or more were defined as higher potency statins. All other statins were categorised as lower potency. The primary outcomes for the study were hospitalisation for new-onset diabetes, or a prescription for insulin or an oral anti-diabetic drug.

In the first two years of regular statin use, the researchers observed a significant 15% increase in the risk of new-onset diabetes with higher potency statins compared with lower potency agents. The risk appeared to be highest in the first four months of use – a significant 26% increase in the risk of developing diabetes, compared with 19% in statin therapy exposure from the fourth month to a year.

The researchers noted that they found ‘modest evidence that there is a harmful association between statin potency and new diabetes in patients treated for secondary prevention of cardiovascular disease’ and that ‘clinicians should consider our study results when choosing between lower potency and higher potency statins in secondary prevention patients’.

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