Victoria A Zigmont1, Abigail B Shoben2, Bo Lu2, Gail L Kaye3, Steven K Clinton4, Randall E Harris1, Susan E Olivo-Marston1. 1. College of Public Health, Division of Epidemiology, The Ohio State University, Columbus, OH, USA. 2. College of Public Health, Division of Biostatistics, The Ohio State University, Columbus, OH, USA. 3. College of Public Health, Division of Health Promotion, The Ohio State University, Columbus, OH, USA. 4. College of Medicine, Department of Internal Medicine, Division of Medical Oncology, The Ohio State University, Columbus, OH, USA.
Abstract
OBJECTIVE: Statins are one of the most widely prescribed medications in the United States; however, there is a concern that they are associated with new-onset-diabetes (NOD) development. We sought to understand the risk of dysglycemia and NOD for a cohort of individuals that reflect real-world physician prescribing patterns. METHODS: A retrospective cohort study was conducted among individuals with indications for statin use (n = 7064). To examine elevated glycosylated hemoglobin (>6.0%), logistic regression with inverse probability weighting was used to create balance between incident statin users and nonusers. To evaluate the risk of NOD development, Cox PH models with time varying statin use compared NOD diagnoses among statin users and nonusers. RESULTS: A higher prevalence of elevated HbA1c (PD = 0.065; 95% CI: 0.002, 0.129, P = 0.045) occurred among nondiabetic incident users of statins. Additionally, statin users had a higher risk of developing NOD (AHR = 2.20; 95% CI: 1.35, 3.58, P = 0.002). Those taking statins for 2 years or longer (AHR = 3.33; 95% CI: 1.84, 6.01, P < 0.001) were at the greatest risk of developing NOD; no differences were observed by statin class or intensity of dose. CONCLUSION: As lifestyle programs like the Diabetes Prevention Program are promoted in primary care settings, we hope physicians will integrate and insurers support healthy lifestyle strategies as part of the optimal management of individuals at risk for both NOD and cardiovascular disease. The relationships between statin use and glycemic control should be evaluated in large cohort studies, medical record databases, and mechanistic investigations to inform clinical judgment and treatment.
OBJECTIVE: Statins are one of the most widely prescribed medications in the United States; however, there is a concern that they are associated with new-onset-diabetes (NOD) development. We sought to understand the risk of dysglycemia and NOD for a cohort of individuals that reflect real-world physician prescribing patterns. METHODS: A retrospective cohort study was conducted among individuals with indications for statin use (n = 7064). To examine elevated glycosylated hemoglobin (>6.0%), logistic regression with inverse probability weighting was used to create balance between incident statin users and nonusers. To evaluate the risk of NOD development, Cox PH models with time varying statin use compared NOD diagnoses among statin users and nonusers. RESULTS: A higher prevalence of elevated HbA1c (PD = 0.065; 95% CI: 0.002, 0.129, P = 0.045) occurred among nondiabetic incident users of statins. Additionally, statin users had a higher risk of developing NOD (AHR = 2.20; 95% CI: 1.35, 3.58, P = 0.002). Those taking statins for 2 years or longer (AHR = 3.33; 95% CI: 1.84, 6.01, P < 0.001) were at the greatest risk of developing NOD; no differences were observed by statin class or intensity of dose. CONCLUSION: As lifestyle programs like the Diabetes Prevention Program are promoted in primary care settings, we hope physicians will integrate and insurers support healthy lifestyle strategies as part of the optimal management of individuals at risk for both NOD and cardiovascular disease. The relationships between statin use and glycemic control should be evaluated in large cohort studies, medical record databases, and mechanistic investigations to inform clinical judgment and treatment.
Authors: Irene García-Fernández-Bravo; Ana Torres-Do-Rego; Antonio López-Farré; Francisco Galeano-Valle; Pablo Demelo-Rodriguez; Luis A Alvarez-Sala-Walther Journal: Front Cardiovasc Med Date: 2022-04-29
Authors: Srikanth Tangelloju; Bert B Little; Robert J Esterhay; Guy Brock; Scott LaJoie Journal: Diabetes Metab Res Rev Date: 2020-04-03 Impact factor: 8.128
Authors: Manuel E Machado-Duque; Diego Arturo Garcia; Melissa Hiromi Emura-Vélez; Andrés Gaviria-Mendoza; Jorge E Machado-Alba Journal: J Prim Care Community Health Date: 2021 Jan-Dec