Background:
It is estimated that nearly 20 million people are taking Statins (HMG-CoA Reductase Inhibitors) currently in the United States. The benefits of statins to treat and prevent cardiovascular disease are accepted universally. However, recent evidence indicates an increased risk of new onset diabetes mellitus (DM) in this population. A literature review was done to analyze available evidence to understand the role of statins in risk incident diabetes and conclude whether this evidence should change current clinical guidelines.
Methods:
A systematic literature search was conducted via the PubMed and Cochrane Library databases limited to Randomized Clinical Trials (RTC) and meta-analyses. Reliable and comparable studies on statin therapy that included DM outcomes were pursued. A manual search was then undertaken using references from studies recovered in the primary search.
Results:
Patients on statins have a higher risk of DM than those given placebo. The range of relative risks was 1.03 to 1.48 with a 95% CI range of [1.02 to 1.59]. Moreover, a higher risk of incident DM was seen in high dose statin use versus standard dose. Pravastatin was associated with the lowest rate of DM, whereas rosuvastatin was associated with the highest.
Conclusions:
A statistically significant relationship exists between statins and risk incidence of DM. Moreover there is a consistent difference in the incidence of new onset DM when comparing different types and doses of statins. However, current research has been unable to decipher a direct mechanism and therefore a cause and effect relationship has not been established. Further studies are needed to absolutely establish the authenticity and power of this relationship. Until that point, there is no reasoning to change guidelines as the net benefits currently outweigh the risks.