Original Research

Journal of General Internal Medicine

, Volume 30, Issue 11, pp 1599-1610

First online:

Statins and New-Onset Diabetes Mellitus and Diabetic Complications: A Retrospective Cohort Study of US Healthy Adults

  • Ishak MansiAffiliated withDepartment of Medicine, VA North Texas Health SystemDepartments of Medicine and Clinical Sciences, University of Texas Southwestern Email author 
  • , Christopher R. FreiAffiliated withPharmacotherapy Division, College of Pharmacy, The University of Texas at AustinPharmacotherapy Education and Research Center, School of Medicine, University of Texas Health Science Center
  • , Chen-Pin WangAffiliated withUniversity of Texas Health Science Center
  • , Eric M. MortensenAffiliated withDepartment of Medicine, VA North Texas Health SystemDepartments of Medicine and Clinical Sciences, University of Texas Southwestern

Abstract

Background

Statin use is associated with increased incidence of diabetes and possibly with increased body weight and reduced exercise capacity. Data on the long-term effects of these associations in healthy adults, however, are very limited. In addition, the relationship between these effects and diabetic complications has not been adequately studied.

Objective

To examine the association between statin use and new-onset diabetes, diabetic complications, and overweight/obesity in a cohort of healthy adults.

Research Design

This was a retrospective cohort study.

Participants

Subjects were Tricare beneficiaries who were evaluated between October 1, 2003 and March 1, 2012. Patients were divided into statin users and nonusers.

Intervention

We excluded patients who, at baseline, had a preexisting disease indicative of cardiovascular diseases, any positive element of the Charlson comorbidity index (including diabetes mellitus), or life-limiting chronic diseases. Using 42 baseline characteristics, we generated a propensity score to match statin users and nonusers.

Main Measures

Outcomes assessed included new-onset diabetes, diabetic complications, and overweight/obesity.

Key Results

A total of 25,970 patients (3982 statin users and 21,988 nonusers) were identified as healthy adults at baseline. Of these, 3351 statins users and 3351 nonusers were propensity score-matched. Statin users had higher odds of new-onset diabetes (odds ratio [OR] 1.87; 95 % confidence interval [95 % CI] 1.67–2.01), diabetes with complications (OR 2.50; 95 % CI 1.88–3.32), and overweight/obesity (OR 1.14; 95 % CI 1.04–1.25). Secondary and sensitivity analyses demonstrated similar findings.

Conclusions

Diabetes, diabetic complications, and overweight/obesity were more commonly diagnosed among statin-users than similar nonusers in a healthy cohort of adults. This study demonstrates that short-term clinical trials might not fully describe the risk/benefit of long-term statin use for primary prevention.

KEY WORDS

Overweight/obesity Diabetes Diabetic complications Adverse events Observational study Satins Primary prevention