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World J Diabetes. Mar 15, 2015; 6(2): 352-357
Published online Mar 15, 2015. doi: 10.4239/wjd.v6.i2.352
Statin use and risk of diabetes mellitus
Bharti Chogtu, Rahul Magazine, KL Bairy
Bharti Chogtu, KL Bairy, Department of Pharmacology, Kasturba Medical College, Manipal University, Manipal, Karnataka 576104, India
Rahul Magazine, Department of Pulmonary Medicine, Kasturba Medical College, Manipal University, Manipal, Karnataka 576104, India
Author contributions: Chogtu B performed the literature search and wrote the initial draft of the paper; Magazine R contributed to writing of paper; Bairy KL has given the final suggestions and editing.
Conflict-of-interest: All authors declare that there is no conflict of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Bharti Chogtu, Associate Professor, Department of Pharmacology, Kasturba Medical College, Manipal University, Manipal, Karnataka 576104, India. bhartimagazine@gmail.com
Telephone: +91-820-2922365 Fax: +91-820-2922083
Received: August 27, 2014
Peer-review started: August 28, 2014
First decision: November 19, 2014
Revised: November 28, 2014
Accepted: December 18, 2014
Article in press: December 19, 2014
Published online: March 15, 2015
Processing time: 204 Days and 3 Hours
Abstract

The 3-hydroxy-methylglutaryl coenzyme A reductase inhibitors, statins, are widely used in the primary and secondary prevention of cardiovascular diseases to lower serum cholesterol levels. As type 2 diabetes mellitus is accompanied by dyslipidemia, statins have a major role in preventing the long term complications in diabetes and are recommended for diabetics with normal low density lipoprotein levels as well. In 2012, United States Food and Drug Administration released changes to statin safety label to include that statins have been found to increase glycosylated haemoglobin and fasting serum glucose levels. Many studies done on patients with cardiovascular risk factors have shown that statins have diabetogenic potential and the effect varies as per the dosage and type used. The various mechanisms for this effect have been proposed and one of them is downregulation of glucose transporters by the statins. The recommendations by the investigators are that though statins can have diabetogenic risk, they have more long term benefits which can outweigh the risk. In elderly patients and those with metabolic syndrome, as the risk of diabetes increase, the statins should be used cautiously. Other than a subset of population with risk for diabetes; statins still have long term survival benefits in most of the patients.

Keywords: New onset diabetes mellitus; Statins; Hyperglycemia; Cardiovascular risk; Dyslipidemia

Core tip: The use of statins in diabetics has long term benefits in terms of decreasing morbidity and mortality. Recent studies have shown that statins increase the incidence of new onset diabetes. The issue became debatable after Food and Drug Administration released changes to statin safety that they increase glycosylated haemoglobin and blood glucose levels. At the same time statins are beneficial in preventing cardiovascular events. Most of the investigators are of the opinion that the risk of diabetes with statins can be outweighed by the long term benefits in preventing complications. In patients with high risk of diabetes, statins should be cautiously used.