Monday, October 12, 2009

Statin-Induced Diabetes: Will It Change Clinical Practice?

Statin-Induced Diabetes: Will It Change Clinical Practice?

  1. L. Maria Belalcazar, MD1,
  2. Vasudevan A. Raghavan, MBBS, MD, MRCP2 and
  3. Christie M. Ballantyne, MD3

+ Author Affiliations

  1. 1Department of Medicine, University of Texas Medical Branch, Galveston, Texas;
  2. 2Division of Endocrinology, Diabetes and Metabolism, Scott and White Hospitals/Texas A&M Health Science Center, Temple, Texas;
  3. 3Department of Medicine, Baylor College of Medicine, and Center for Cardiovascular Disease Prevention, Methodist DeBakey Heart and Vascular Center, Houston, Texas.
  1. Corresponding author: Christie M. Ballantyne,
An increase in the incidence of physician-diagnosed diabetes with rosuvastatin in Justification for the Use of Statins in Primary Prevention: an Intervention Trial Evaluating Rosuvastatin (JUPITER) published recently revived clinical interest in the effects of statins on glycemic control. The study showed that, after almost 2 years of follow-up in men and women with elevated levels of high-sensitivity C-reactive protein but average LDL cholesterol, rosuvastatin therapy was associated with a mild but significant increase in the identification of new-onset diabetes (3% in the statin arm, 2.4% in the placebo arm; P < 0.01) (1). The potential association between statin use and new-onset diabetes gained attention in 2001 when a post hoc analysis of another primary prevention statin trial, the West of Scotland Coronary Prevention Study (WOSCOPS), reported that treatment with pravastatin decreased the hazard of developing type 2 diabetes by 30% (hazard ratio 0.7 [95% CI 0.5–0.99]; P = 0.042) (2). These seemingly contradictory findings flank results from four other statin trials that failed to uncover a significant relationship between statin use and incident type 2 diabetes when the latter was evaluated as a tertiary end point (36).

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