Statins slightly up diabetes risk

People taking statins are at a slightly increased risk of diabetes, but this risk is low in absolute terms and the benefits outweigh the risks, researchers say. Writing in the Lancet, the British researchers stress that clinical practice should therefore remain unchanged in patients with moderate or high cardiovascular risk. Their meta-analysis of 13 controlled statin trials including more than 90,000 participants found that statin therapy was associated with a 9% increased risk for diabetes compared with placebo or standard care. The risks were higher in trials with older participants, will little heterogeneity between trials. There was also no difference between hydrophilic and lipophilic statins. “These results do not prove that statin therapy raises diabetes risk via a molecular mechanism, although this possibility should be considered,” they said, adding that residual confounding factors may also explain the association. “In view of the overwhelming benefit of statins for reduction of cardiovascular events, the small absolute risk for development of diabetes is outweighed by cardiovascular benefit in individuals for whom statin therapy is recommended,” they said. In addition, they estimated that statin therapy would reduce the number of major coronary events by 5.4 events per 255 patients treated for 4 years compared with control therapy. “We therefore suggest that clinical practice for statin therapy does not need to change for patients with moderate or high cardiovascular risk or existing cardiovascular disease. However, diabetes risk should be taken into account for patients at low cardiovascular risk or [those] in which cardiovascular benefit has not been proven,” they concluded. An accompanying editorial agreed that this newly identified risk warranted monitoring. “In addition to periodic monitoring of liver-function tests and creatine kinase, it seems reasonable to add glucose to the list of tests to monitor in older patients who are on statins”, it concluded. The Lancet; published online first February 17...