COMMENTARY

Statins and Diabetes: Should We Be Worried?

Sandra Adamson Fryhofer, MD

Disclosures

April 21, 2014

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Hello. I'm Dr. Sandra Fryhofer. Welcome to Medicine Matters. The topic: statins, diuretics, and the risk for diabetes, a new study in the British Medical Journal.[1] Here's why it matters.

Diabetes is linked to increased risk for heart disease. Statin therapy, along with blood pressure meds, including diuretics and beta-blockers, are used to manage cardiovascular risk factors. But results of recent data have linked both long-term use of statins and long-term use of diuretics to increased diabetes risk. Beta-blockers have been linked to impaired blood sugar control. But how significant is this link, and to what degree? That's what this new study looking at data from the NAVIGATOR trial set to find out.

The NAVIGATOR study included a group of patients with baseline impaired glucose tolerance. During the course of this 5-year study, roughly 1000 patients were newly started on beta-blockers. More than 1300 were started on statins and/or diuretics. And more than 1100 were started on calcium channel blockers, which were considered to be the metabolically neutral control.

The results: After adjusting for baseline characteristics and confounders, the link was clear. Both statins and diuretics were linked to new-onset diabetes, a 23% increased risk. In this study, use of beta-blockers and calcium channel blockers was not linked to diabetes.

The US Food and Drug Administration mandated a statin safety labeling change[2] in 2012 as an alert to this increased diabetes risk. This is an observational study. But the researchers say blood sugars should be more closely monitored in patients with impaired glucose tolerance who are taking statins and/or diuretics.

For Medicine Matters, I'm Dr. Sandra Fryhofer.

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