Opinion Former Article

Intensive-dose statin therapy associated with increased risk of diabetes

Intensive-dose statin therapy associated with increased risk of diabetes


An analysis of data from previously published studies indicates that

intensive-dose statin therapy is associated with an increased risk of

new-onset diabetes compared with moderate-dose therapy, according to a

study in the June 22/29 issue of JAMA.


Compared with placebo, statin therapy significantly reduces

cardiovascular events among individuals with and without a history of

diabetes mellitus. Recently, findings of several trials comparing

intensive- to moderate-dose statin therapy suggested an excess risk of

new diabetes among those treated with intensive statin regimens,

according to background information in the article. According to the

authors, "Given the cardiovascular benefits of statins and the likely

increasing use of intensive statin regimens, it is important to

quantify any potential long-term risks to enable physicians and

patients to make informed choices."


David Preiss, M.R.C.P., of the University of Glasgow, United Kingdom,

and colleagues examined the associations of intensive-dose statin

therapy vs. moderate-dose therapy with the development of diabetes and

the occurrence of major cardiovascular events by conducting a

meta-analysis of published and unpublished data from relevant clinical

trials. The researchers identified 5 statin trials that met criteria

for inclusion in the analysis.


The 5 randomized clinical trials provided data on 32,752 nondiabetic

participants over a weighted average follow-up of 4.9 years. During

follow-up, 2,749 participants (8.4 percent) developed diabetes (1,449

of whom were assigned intensive-dose therapy, 1,300 assigned

moderate-dose therapy), and 6,684 (20.4 percent) experienced a major

cardiovascular event (3,134 assigned intensive-dose therapy, 3,550

assigned moderate-dose therapy). There were 149 more cases of incident

diabetes in participants assigned to intensive statin treatment than

in those receiving moderate therapy and 416 fewer patients with

cardiovascular events who received intensive-dose therapy.


An analysis of the data indicated that use of intensive-dose statin

therapy compared with moderate-dose statin therapy was associated with

a higher incidence of new-onset diabetes. However, intensive statin

therapy was associated with fewer major cardiovascular events. As

compared with moderate-dose statin therapy, the number needed to harm

per year for intensive-dose statin therapy was 498 for new-onset

diabetes while the number needed to treat per year for intensive-dose

statin therapy was 155 for cardiovascular events.


"Our findings suggest that clinicians should be vigilant for the

development of diabetes in patients receiving intensive statin

therapy," the authors write. "In conclusion, this meta-analysis

extends earlier findings of an increased incidence of diabetes with

statin therapy by providing evidence of a dose-dependent association."



(JAMA. 2011;305[24]2556-2564. Available pre-embargo to the media at



Editor's Note: Please see the article for additional information,

including other authors, author contributions and affiliations,

financial disclosures, funding and support, etc.


To contact corresponding author David Preiss, M.R.C.P., email

david.preiss@glasgow.ac.uk; for Kausik K. Ray, M.D., email



Huw Beale
Senior Media Officer

Diabetes UK
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