Association of Statin Therapy Initiation with Diabetes Progression

Statin therapy has been associated with increased insulin resistance; however, its clinical implications for diabetes control among patients with diabetes is unknown. To assess this, a large retrospective cohort study was conducted with 12 years data of 83, 022 propensity-scored matched pairs of statin users and nonusers covered by the US Department of Veterans Affairs from fiscal years 2003 to 2015. Patients included were 30 years or older; diagnosed with diabetes during the study period; and were regular users of the Veterans Affairs health system, with records of demographic information, clinical encounters, vital signs, laboratory data, and medication usage. Diabetes progression composite outcome comprised the following: new insulin initiation, increase in the number of glucose-lowering medication classes, incidence of 5 or more measurements of blood glucose of 200 mg/dL or greater, or a new diagnosis of ketoacidosis or uncontrolled diabetes. Diabetes progression outcome occurred in 55.9% of statin users vs 48.0% of active comparators with odds ratio of 1.37 and significance of less than < .001. Each individual component of the composite outcome was significantly higher among statin users. Secondary analysis demonstrated a dose-response relationship with a higher intensity of LDL-cholesterol lowering associated with greater diabetes progression. To conclude, this retrospective matched-cohort study found that statin use was associated with diabetes progression, including greater likelihood of insulin treatment initiation, significant hyperglycaemia, acute glycaemic complications, and an increased number of prescriptions for glucose-lowering medication classes. The risk-benefit ratio of statin use in patients with diabetes should be take into consideration by the health care professionals. Disclaimer: Lupin makes no representation or warranty of any kind, expressed or implied, regarding the accuracy, adequacy, validity, reliability, availability, or completeness of any scientific information shared by the HCP on the ­­­STAR UPDATE podcast. You should not allow the contents of this to substitute for your own medical judgment, which you should exercise in evaluating the information on this website.