Statins and the risk of developing diabetes

Statins are the cornerstone of treatment for dyslipidaemia, but a recent meta-analysis of randomised trials found an association between their use and incident diabetes.1 In a linked observational study (doi:10.1136/bmj.f2610), Carter and colleagues provide an important contribution to this topic.2 Using an epidemiological approach, they analysed administrative claims data from Ontario, Canada, to retrospectively examine the comparative risk of incident diabetes for different statins in users aged over 66 years. They found that, compared with pravastatin, treatment with atorvastatin, rosuvastatin, or simvastatin—but not fluvastatin or lovastatin—was associated with an increased risk of incident diabetes in statin-naive older patients without diabetes. The risk of incident diabetes did not differ between patients with or without cardiovascular disease. Importantly, in line with a meta-analysis showing increased risk of diabetes for an intensive statin dose versus a moderate dose,3 Carter and colleagues found an association between development of overt diabetes and potency and dose of …