Editorials

Increased risk of glucose intolerance and type 2 diabetes with statins

BMJ 2011; 343 doi: http://dx.doi.org/10.1136/bmj.d5004 (Published 08 August 2011) Cite this as: BMJ 2011;343:d5004
  1. Christopher D Byrne, professor of endocrinology and metabolism1,
  2. Sarah H Wild, reader in epidemiology and public health2
  1. 1Institute of Developmental Sciences, University of Southampton, Southampton General Hospital, Southampton SO16 6YD, UK
  2. 2Centre for Population Health Sciences, University of Edinburgh, Edinburgh, UK
  1. cdtb{at}soton.ac.uk

In people with a moderate or high risk of cardiovascular disease, benefits of statins still outweigh the risks

Statins are considered a 21st century panacea to the extent that some people propose they should be taken by everyone over 55 years of age.1 Convincing evidence shows that statins reduce all cause mortality and prevent or postpone cardiovascular disease,2 and that in general they are well tolerated, with 11 cases of myopathy (the most serious side effect) occurring per 100 000 person years of treatment.3

However, accumulating evidence suggests that statins worsen glucose tolerance and possibly cause type 2 diabetes. This suggests a parallel with thiazides and β blockers, which are also known to increase plasma glucose, thus creating concerns over the risks of treatment versus benefit.4 An analysis of West of Scotland Coronary Prevention Study (WOSCOPS) data concluded in 2001 that randomisation to pravastatin significantly reduced the risk of developing diabetes (hazard ratio after adjusting for age, body mass index, white blood cell count, blood pressure, lipids, alcohol intake, smoking, and glucose at baseline 0.70, 95% confidence interval 0.50 to 0.99).5 This conclusion was based on 1.9% of 2999 men in the pravastatin group and 2.8% of 2975 men in the comparison …

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