Statins and Incident Diabetes: Can Risk Outweigh Benefit?

  • Roberta Florido
  • Annie Elander
  • Roger S. Blumenthal
  • Seth S. Martin
Diabetes + Insulin Resistance (M Rutter, Section Editor)
First Online:
Part of the following topical collections:
  1. Topical Collection on Diabetes + Insulin Resistance

Abstract

We review the most recent data regarding the association of incident diabetes and statin use, examine potential mechanisms to explain this association, and compare the potential risk of diabetes with the known cardiovascular benefits derived from statin use. We discuss new and interesting findings, as well as significant trends and developments. The risk of statin-induced dysglycemia and diabetes appears to be dose-dependent, but generally small in magnitude and confined to an unmasking of a strong predisposition to diabetes or accelerated diagnosis in individuals with diabetes risk factors. We focus on the concept of net benefit and find that although risk of diabetes could outweigh cardiovascular benefits in select individuals at low cardiovascular risk, the vast majority of people being managed for cardiovascular risk are most likely to derive net benefit. The need to weigh risks and benefits highlights the importance of shared decision-making in clinician-patient risk discussions.

Keywords

Statins HMG Co-A reductase inhibition Diabetes Hyperglycemia Insulin resistance Hypercholesterolemia Atherosclerosis Treatment Guidelines 
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Notes

Acknowledgments

SSM is supported by the Pollin Cardiovascular Prevention Fellowship, Marie-Josée and Henry R. Kravis endowed fellowship, and a National Institutes of Health training grant (T32HL07024). RSB is supported by the Kenneth Jay Pollin Professorship in Cardiology. The authors did not receive any dedicated funding to write this article.

Compliance with Ethics Guidelines

ᅟ

Conflict of Interest

Roger Blumenthal and Roberta Florido have no disclosures. Seth Martin is listed as a co-inventor on a pending patent filed by Johns Hopkins University for a method of low-density lipoprotein cholesterol estimation.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by the author.

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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Roberta Florido
    • 1
    • 2
  • Annie Elander
    • 1
  • Roger S. Blumenthal
    • 1
    • 2
  • Seth S. Martin
    • 1
    • 2
  1. 1.Johns Hopkins Ciccarone Center for the Prevention of Heart DiseaseBaltimoreUSA
  2. 2.The Johns Hopkins HospitalBaltimoreUSA

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