6533b827fe1ef96bd1287071
RESEARCH PRODUCT
The use of statins in people at risk of developing diabetes mellitus: Evidence and guidance for clinical practice
Richard CeskaNaveed SattarElena BilianouShun IshibashiTamio TeramotoVincent MaherPaul ValensiLuis MasanaKausik K. RayPaul D. FlynnHenry N. GinsbergJohn J.p. KasteleinXavier Garcia-mollSelim JambartIbrahim SaltiD. John BetteridgeCarlo Maria RotellaRaimund ErbelDeepak BhatnagarTerje R. PedersenPeter P. TothLale TokgozogluMasato OdawaraBruno VergèsMarcello ArcaRafael CarmenaAlberto CorsiniJanusz GumprechtM. John ChapmanMaurizio AvernaPedro Marques Da Silvasubject
MaleSettore MED/09 - Medicina Internaendocrine system diseasesHSM MEDHydroxymethylglutaryl-CoA Reductase Inhibitors/adverse effectsAnticholesteremic Agents/adverse effectsMedizin1567-5688ComorbidityType 2 diabetesPharmacologyDiabeteHydroxymethylglutaryl-CoA Reductase Inhibitors/administration & dosageCardiovascularFasting/bloodCohort StudiesRisk FactorsAnticholesteremic Agents/administration & dosageDiabetes Mellitus Type 2/prevention & controlMulticenter Studies as TopicMedicineT2DDiabetisAnticholesteremic AgentsDiabetesHemoglobin A Glycosylated/analysisFastingGeneral MedicineMiddle AgedDiabetogenicityCVDClinical PracticeObservational Studies as TopicCholesterol LDL/bloodCardiovascular DiseasesPractice Guidelines as Topiclipids (amino acids peptides and proteins)Disease SusceptibilityCardiology and Cardiovascular MedicineRisk assessmentCardiovascular Diseases/prevention & controlCohort studyAdultmedicine.medical_specialtyStatinHydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic usemedicine.drug_classAnticholesteremic Agents/therapeutic useHydroxymethylglutaryl-CoA Reductase Inhibitors/pharmacologyDiabetes Mellitus Type 2/etiologyRisk AssessmentMulticenter Studies as Topic/statistics & numerical dataPrediabetic StateMeta-Analysis as TopicDiabetes mellitusInternal MedicineHumansIntensive care medicinePrediabetic State/epidemiologyGlycated HemoglobinStatins; Diabetes; Diabetogenicity; T2D; Cardiovascular; CVDbusiness.industryCardiovascular Diseases/epidemiologyStatinsStatinnutritional and metabolic diseasesCholesterol LDLmedicine.diseaseComorbidityAnticholesteremic Agents/pharmacologyDiabetes Mellitus Type 2/epidemiologyDiabetes Mellitus Type 2Estatines (Medicaments cardiovasculars)Observational Studies as TopicHydroxymethylglutaryl-CoA Reductase InhibitorsbusinessObservational Study as TopicForecastingdescription
Reducing low-density lipoprotein cholesterol (LDL-C) levels using statins is associated with significant reductions in cardiovascular (CV) events in a wide range of patient populations. Although statins are generally considered to be safe, recent studies suggest they are associated with an increased risk of developing Type 2 diabetes (T2D). This led the US Food and Drug Administration (FDA) to change their labelling requirements for statins to include a warning about the possibility of increased blood sugar and HbA1c levels and the European Medicines Agency (EMA) to issue guidance on a small increased risk of T2D with the statin class. This review examines the evidence leading to these claims and provides practical guidance for primary care physicians on the use of statins in people with or at risk of developing T2D. Overall, evidence suggests that the benefits of statins for the reduction of CV risk far outweigh the risk of developing T2D, especially in individuals with higher CV risk. To reduce the risk of developing T2D, physicians should assess all patients for T2D risk prior to starting statin therapy, educate patients about their risks, and encourage risk-reduction through lifestyle changes. Whether some statins are more diabetogenic than others requires further study. Statin-treated patients at high risk of developing T2D should regularly be monitored for changes in blood glucose or HbA1c levels, and the risk of conversion from pre-diabetes to T2D should be reduced by intensifying lifestyle changes. Should a patient develop T2D during statin treatment, physicians should continue with statin therapy and manage T2D in accordance with relevant national guidelines. (C) 2014 Published by Elsevier Ireland Ltd.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2014-01-01 |