Read on to learn more about the different types of diabetes and their potential causes. What is a dangerously high A1C level? Read on to learn more about the A1C test, what the results show, and how people can lower their A1C level. Eating a variety of fruits is important, but some fruits are better than others for people with diabetes. Learn more. Study uncovers why statins increase diabetes risk and offers solution Written by Marie Ellis on June 12, Glyburide taken with statins suppressed immune response.
Share on Pinterest Though statins can prevent heart disease by lowering cholesterol, they also increase risks for developing type 2 diabetes.
Written by Marie Ellis on June 12, Exposure to air pollutants may amplify risk for depression in healthy individuals. Costs associated with obesity may account for 3. Related Coverage. In addition, studies where the sample size of patients with diabetes was more than with a mean follow-up of more than one year were included. Studies including patients on statin therapy with organ transplant, or hemodialysis were excluded for evaluation. Studies with single statin, or those in which diabetic patients on statin therapy with a sample size of less than were also excluded from the evaluation.
Trials assessing change in surrogate markers of cardiovascular diseases and trials with a mean follow-up of one year, or less were also excluded. An exhaustive search strategy was developed to identify the studies for this review.
Main outcomes of the study were analyzed by tabulation. Any significant differences in the comparison were recorded in the results section and interpreted logically.
Risk of diabetes after statin therapy was the main result of this study. The Cochran Q, a Chi square based test was used to assess the heterogeneity between study variability in the meta-analysis. Random effects model of meta-analysis was used for data analysis. Publication bias was investigated by using the funnel plots constructed based on the standard error by log odds ratio OR. Fourteen studies were found to provide the relevant data as per the criteria and were shortlisted Figure 1.
The mean study follow-up was 4 years Table 1. The relative percentage reduction in blood cholesterol across the people subjected to statin therapy considered during the current review is presented in Table 2. New onset of diabetes in non-diabetic participants in 14 placebo controlled and standard care controlled statin therapy trials.
Trends in LDL-C reduction in non-diabetic participants in 14 placebo controlled and standard care controlled statin therapy trials. Rate of diabetes incidence in individual trials were found to be drastically varied Figure 2. Since the heterogeneity was very low, variation was not attributable to chance alone. Association between statin therapy and incident diabetes in 14 major randomized controlled trials.
Cumulative analysis showed that the positive effect of statins on diabetes initiation appeared after sixth 32 and significance after the eleventh 30 Figure 3.
Funnel plot showed that publication bias was absent as the studies were distributed symmetrically on both sides of the combined effect size and no imputed studies were plotted Figure 4. Cumulative meta-analysis of the studied clinical trial by year of publication. Funnel plot of standard error by log odds ratio for the included studies on statin induced diabetes. The OR was further analyzed based on the type of statins Figure 5.
Association between individual statins and incidental diabetes mellitus. The incidence of diabetes in the study population was highest in the placebo groups in the simvastatin trials 5. While this was lower than the treated groups in all statins, it was higher compared with the lovastatin treated subjects.
The incidence was significant for atorvastatin and rosuvastatin as compared with the placebo group. Compared with lovastatin, the OR of developing incidental diabetes with pravastatin was 1.
The present work is a meta-analysis of the incidence of diabetes mellitus upon chronic use of statins. The analysis of data showed that subjects treated with statins have a slightly higher chance of developing diabetes as compared to placebo, or standard care.
Further analysis involving the comparison of different statins on diabetes incidence showed that only 2 statins, atorvastatin and rosuvastatin, showed significant association with diabetes whereas other 3 statins showed no significant incidence. Although no insights into the mechanism of these associations can be adjudged, one previous study 34 conducted to evaluate the effects of statins on glucose transporters showed that except atorvastatin, other statins exert no detrimental effects.
Therefore, the association of diabetes incidence with atorvastatin and rosuvastatin treatment was likely due to the inhibition of glucose transporters and needs further research. Statins affect insulin sensitivity through several mechanisms. A meta-analysis of 16 statin studies reporting insulin sensitivity data revealed that pravastatin can reduce the insulin secretion whereas other statins including atorvastatin, simvastatin and rosuvastatin has no such effect over insulin.
Other studies have suggested that altered glucose uptake by decreased glucose transporter type 4 expression or translocation might be the mechanism. This reflects the variation in clinical effects observed with different statins. Leptin, an adipocyte-secreted hormone is another pathway through which statins may act. Leptin resistance or lowered leptin levels are believed to promote insulin resistance, leading to diabetes through a complex mechanism, including lowered insulin secretion and beta-cell depletion.
Other mechanisms proposed are inhibition of glucose-induced cytosolic calcium signaling and insulin secretion through blockage of L-type calcium channels, 40 impaired insulin secretion through an indirect mechanism related to chronic cholesterol depletion, 41 and statin associated weight gain. However, these findings need substantial future research to associate with the observed statin effects.
Another potential explanation based on the residual confounding factors suggest that improved survival, or change in lifestyle with statin therapy may promote diabetes.
Editor's Note: These materials were made possible by a grant from the state Attorney General Consumer and Prescriber Education Grant Program, which is funded by a multistate settlement of consumer fraud claims regarding the marketing of the prescription drug Neurontin gabapentin.
My science background and years of working as a medical journalist enable me to help consumers make informed medication choices. Follow me on Twitter.
Sign In. Become a Member. Remember Me. Forgot username or password? Not a member? Need further assistance? Please call Member Services at But the benefit of taking these statins often still outweighs the risks. Additionally, the analysis revealed that those who took statins had a 6. Also, having access to biometric measurements meant the researchers could consider and adjust for values before statin use.
Furthermore, all participants were white. Finally, the researchers could not account for other medications that the participants might have taken, nor did they consider other health habits, such as smoking status or alcohol use. Similarly, the researchers were unaware whether the participants had prediabetes at the start of the study or not.
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