Statins and risk of incident diabetes: a collaborative meta-analysis of randomised statin trials

Sattar N, Preiss D, Murrary HM, et al. Statins and risk of incident diabetes: a collaborative meta-analysis of randomised statin trials. Lancet. 2010;375(9716):735-742.  

Sattar and colleagues conducted a meta-analysis to assess whether a relationship between statin use and development of diabetes exists. Published and unpublished data from randomized placebo- and standard care-controlled trials assessing the effects of statins on cardiovascular disease (CVD) endpoints were examined; trials comparing statins, examining statin use in subjects with diabetes, assessing change in surrogate CVD markers, with ≤1,000 subjects, and with ≤1 year of follow-up were excluded.

Thirteen studies (7 unpublished) from 1994–2009 were included in the meta-analysis. Odds ratios (OR) and 95% confidence intervals (CI) were calculated to assess the number of subjects with no diabetes at baseline and those developing diabetes during the study period. Standard diabetes diagnostic criteria were used in the assessment; heterogeneity between trials was also examined.

Results:
Of the 13 trials examined, 4,278 subjects out of 91,140 developed incident diabetes over a mean 4-year follow up. When data from all studies were combined, there was a 9% increase (N=174) in additional cases of incident diabetes during follow-up among subjects receiving statin therapy vs those receiving placebo or standard care, which can also be expressed in absolute terms as one additional case of diabetes per 255 (95% CI, 150–852) subjects receiving statin therapy for 4 years (12.23 cases per 1,000 patient-years with statin treatment and 11.25 cases per 1,000 patient-years for those receiving control therapy).

When only placebo-controlled studies were examined, risk of incident diabetes remained higher with subjects receiving statin therapy vs those in the control group (OR, 1.10; 95% CI, 1.01–1.20, I²=21%; N=75,507). The association weakened slightly (OR, 1.07; 95% CI, 0.97–1.17, I²=32%; N=75,033) when trials using only fasting glucose measurements were assessed.

No clear difference between statins was observed with regard to diabetes risk, and heterogeneity between trials included in the analysis was low.

 

October 2012  

This overview was created by KnowledgePoint360 Group, LLC, and was not associated with funding via an educational grant or a promotional/commercial interest.  

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Last Modified: 3/23/2015