Do Statins Increase the Risk of Diabetes Development?
Statins were found to increase the risk of diabetes especially with more intensive statin therapy, an analysis published in Pharmacoepidemiology and Drug Safety has found.
Data from randomized-controlled trials have provided inconsistent findings regarding the relationship between statins and diabetes. Sunita Nair, of Capita India Pvt. Ltd., and researchers conducted a systematic literature review and network meta-analysis to update data on this association to better assist clinicians in their decision-making of treatment options.
The team searched databases such as Embase, Cochrane, and PubMed for studies published between August 2010 and June 2014. Data synthesis was performed by pairwise meta-analysis and network meta-analysis within a Frequentist framework. A total of 29 trials including 163,039 participants were included for the review, of which 141,863 patients were non-diabetic.
Results from the direct meta-analysis showed that statins overall significantly increased the risk of developing diabetes by 12% (pooled odds ratio [OR] 1.12, 95% CI: 1.05–1.21;P=0.002). According to the network meta-analysis, atorvastatin 80mg carried the highest risk of diabetes (OR 1.34, 95% CI: 1.14–1.57), followed by rosuvastatin (OR 1.17, 95% CI: 1.02–1.35).
OR values obtained for other statins were as follows: simvastatin 80mg (OR 1.21, 95% CI: 0.99–1.49) simvastatin (OR 1.13, 95% CI: 0.99–1.29), atorvastatin (OR 1.13, 95% CI: 0.94–1.34), pravastatin (OR 1.04, 95% CI: 0.93–1.16), lovastatin (OR 0.98, 95% CI: 0.69–1.38), and pitavastatin (OR 0.74, 95% CI: 0.31–1.77). High-dose atorvastatin was found to increase the likelihood of developing diabetes even when compared with pravastatin, simvastatin, and low-dose atorvastatin in the network meta-analysis.
The statin class showed an increased risk of diabetes in the pairwise meta-analysis. Nair and coauthors noted that more data would be beneficial in strengthening the analyses' findings as the low confidence intervals were close to, or just crossing one.
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