Lower and higher-potency statins on glycemic control in type 2 diabetes: A retrospective cohort study

• Statins are the most effective drugs for the treatment of hypercholesterolemia.
• Statin therapy has been associated with incident diabetes.
• In type 2 diabetes, statins determine a mild deterioration of glycemic control.
• Higher-potency statins require more frequent diabetes intensification therapy.

AimsEvidences showed a link between statins and new-onset diabetes and large clinical trials in type 2 diabetes (T2DM) suggested a mild glycemic progression in statin treated. Since this effect has not yet elucidated in real world, we investigated the effects of different statins on glycemia in T2DM clinic outpatients.MethodsIn a retrospective cohort study, we recorded at 6 and 12 months modifications of fasting glucose (FPG), HbA1c, diabetes intensification therapy and target rate for HbA1c in 421 T2DM non-users and new statin users. Statins were categorized with low or high potency.ResultsCompared to statin users, no statin group showed a significant HbA1c reduction from 52.8 ± 14.0 mmol/mol to 48.2 ± 8.5 (p = 0.003) at 6 months and 48.6 ± 8.8 (p = 0.007) at 12 months. This trend without statins was also observed in FPG starting from 7.1 ± 2.0 mmol/l to 6.7 ± 1.6 (p = 0.12) at 6 months and 6.6 ± 1.5 (p = 0.032) at 12 months. Statins determined a significant diabetes treatment intensification: 48.7% vs 27.4% (p = 0.002) with hazard ratio 2.4 [95% CI 1.14–5.2], p = 0.022. HbA1c target was significantly lower in statin users 62.0% vs 75.4%, p = 0.042. Only lower-potency statins showed a significant reduction of HbA1c from 52.0 ± 11.1 mmol/mol to 50.7 ± 9.0 (p = 0.017) and 50.7 ± 9.5 (p = 0.038) at 6 and 12 months, respectively. The same effect for these statins was registered in FPG from 7.5 ± 2.2 mmol/l to 7.0 ± 1.6 (p = 0.021) at 6 months and 7.2 ± 1.5 (p = 0.026) at 12 months.ConclusionsIn patients receiving statin therapy a greater intensification diabetes therapy is need. This impact seems to be less pronounced by statins with lower potency.