Risk of incident diabetes among patients treated with statins

Muhammad Mamdani Director, Applied Health Research Centre, St. Michael's Hospital  Scientist in the Keenan Research Centre of the Li Ka Shing Knowledge Institute of St. Michael's HospitalMedicalResearch.com eInterview with Muhammad Mamdani

Director, Applied Health Research Centre, St. Michael’s Hospital
Scientist in the Keenan Research Centre of the Li Ka Shing Knowledge Institute
of St. Michael’s Hospital
Associate Professor, Department of Health Policy, Management, and Evaluation University of Toronto

MedicalResearch.com: What are the main findings of this study?

Our study examined over 470,000 elderly patients initiated on statins and followed them for incident diabetes.

Our findings suggest that certain statins including atorvastatin, rosuvastatin, and simvastatin may have a small but higher risk of incident diabetes relative to other statins such as pravastatin, lovastatin, and fluvastatin.

Our findings are largely consistent with previous data from large randomized clinical trials, although our study is the largest to date to specifically compare individual statins with one another for this particular outcome.

While the risk of incident diabetes appears to be elevated for certain statins, the magnitude of elevation may be rather small. For example, for every 1,000 patients treated with atorvastatin, rosuvastatin, or simvastatin we may expect 6-10 additional cases of diabetes had they been treated with pravastatin, lovastatin, or fluvastatin instead. Some patients may require the higher potency statins such as atorvastatin or rosuvastatin to best manage their cholesterol, however most patients may fare well with statins with perhaps lower risk of incident diabetes such as pravastatin.

The findings of this study may assist patient and clinician discussions when discussing the risks and benefits of statin therapy.

Citation:

Carter AA ,Gomes T ,Camacho X ,Juurlink DN ,Shah BR ,Mamdani MM. Risk of incident diabetes among patients treated with statins: population based study.
BMJ 2013;346:f2610

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