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. 

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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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