Publications

Published: September 2012

Statins - A Risk of Diabetes Mellitus?

Prescriber Update 33(3): 24-25
September 2012

Statins, HMG-CoA reductase inhibitors, are one of the most widely prescribed classes of medicinal products in New Zealand. PHARMAC estimates that over 1.7 million statin prescriptions were written for over 400,000 patients during 2011.

Recent publications have suggested that there may be an association of new-onset type 2 diabetes mellitus (T2DM) with the use of statins1, 2. The Medicines Adverse Reactions Committee (MARC) have reviewed the relevant studies and concluded that there is a small, but statistically significant association, particularly in patients already at risk of T2DM. Nevertheless, the MARC considered that the benefits of statin treatment clearly outweigh any risk of developing new-onset T2DM.

A total of six meta-analyses were reviewed by the MARC. The studies all had limitations and suggest that other individual risk factors may also contribute to the association. The risk factors included:

There was insufficient data to exclude an effect with any individual statin or to support a dose-dependent relationship. Further information on this issue can be found at www.medsafe.govt.nz/profs/adverse/Minutes150.htm

Healthcare professionals should be aware of the association of new-onset T2DM with the use of statins and are advised to monitor at risk patients according to best practice guidelines (see www.bpac.org.nz or www.nzgg.org.nz for further information).

Key Messages

  • The MARC considered the evidence suggests an association of new-onset T2DM with the use of statins. However, any risk appears to be mainly in patients already at increased risk of developing diabetes.
  • The cardiovascular benefits of statin therapy continue to outweigh the risk of patients developing diabetes.
  • There is insufficient evidence to confirm or exclude an increased risk for individual statins or support a dose-dependent relationship.
References
  1. Sattar N, Preiss D, Murray HM et al. 2010. Statins and risk of incident diabetes: a collaborative meta-analysis of randomised statin trials. Lancet 375: 735-42.
  2. Culver AL, Ockene IS, Balasubramanian R, et al. 2012. Statin use and risk of diabetes mellitus in postmenopausal women in the Women's Health Initiative. Archives of Internal Medicine 172: 144-52.