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Comparative Study
. 2013 May 23:346:f2610.
doi: 10.1136/bmj.f2610.

Risk of incident diabetes among patients treated with statins: population based study

Aleesa A Carter  1 , Tara Gomes, Ximena Camacho, David N Juurlink, Baiju R Shah, Muhammad M Mamdani
Affiliations
Comparative Study

Risk of incident diabetes among patients treated with statins: population based study

Aleesa A Carter et al. BMJ. .

Erratum in

  • BMJ. 2013;347:f4356

Abstract

Objective: To examine the risk of new onset diabetes among patients treated with different HMG-CoA reductase inhibitors (statins).

Design: Population based cohort study with time to event analyses to estimate the relation between use of particular statins and incident diabetes. Hazard ratios were calculated to determine the effect of dose and type of statin on the risk of incident diabetes.

Setting: Ontario, Canada.

Participants: All patients aged 66 or older without diabetes who started treatment with statins from 1 August 1997 to 31 March 2010. The analysis was restricted to new users who had not been prescribed a statin in at least the preceding year. Patients with established diabetes before the start of treatment were excluded.

Interventions: Treatment with statins.

Main outcome measure: Incident diabetes.

Results: Compared with pravastatin (the reference drug in all analyses), there was an increased risk of incident diabetes with atorvastatin (adjusted hazard ratio 1.22, 95% confidence interval 1.15 to 1.29), rosuvastatin (1.18, 1.10 to 1.26), and simvastatin (1.10, 1.04 to 1.17). There was no significantly increased risk among people who received fluvastatin (0.95, 0.81 to 1.11) or lovastatin (0.99, 0.86 to 1.14). The absolute risk for incident diabetes was about 31 and 34 events per 1000 person years for atorvastatin and rosuvastatin, respectively. There was a slightly higher [corrected] absolute risk with simvastatin (26 outcomes per 1000 person years) compared with pravastatin (23 outcomes per 1000 person years). Our findings were consistent regardless of whether statins were used for primary or secondary prevention of cardiovascular disease. Although similar results were observed when statins were grouped by potency, the risk of incident diabetes associated with use of rosuvastatin became non-significant (adjusted hazard ratio 1.01, 0.94 to 1.09) when dose was taken into account.

Conclusions: Compared with pravastatin, treatment with higher potency statins, especially atorvastatin and simvastatin, might be associated with an increased risk of new onset diabetes.

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Conflict of interest statement

Competing interests: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf (available on request from the corresponding author) and declare that MMM has received honoraria from Boehringer Ingelheim, Sanofi-Aventis, Lilly, Pfizer, Bristol-Myers Squibb, Merck and Bayer.

Figures

None
Adjusted survival curves for incident diabetes among new users of statins
See this image and copyright information in PMC

Comment in

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