Deterioration of glucose homeostasis in type 2 diabetic patients one year after beginning of statins therapy

Atherosclerosis. 2012 Jul;223(1):197-203. doi: 10.1016/j.atherosclerosis.2012.04.015. Epub 2012 May 8.

Abstract

Objective: We evaluated the long-term effects of rosuvastatin and simvastatin on insulin sensitivity and secretion in patients with well-controlled type 2 diabetes.

Methods: After a 3 weeks run-in, 27 eligible patients were randomly assigned to receive either rosuvastatin 20 mg daily (Group 1) or simvastatin 20 mg daily (Group 2) for 6 months; thereafter they were switched to the other treatment for additional 6 months. Patients were recruited among individuals attending the outpatient service of the Diabetology Unit of the "Policlinico Tor Vergata" University Hospital, Rome, Italy. Serum lipids, glucose and insulin, glycated hemoglobin, C-reactive protein, TNF-α, leptin, adiponectin, insulin sensitivity by euglycemic-hyperinsulinemic clamp, β-cells function by HOMA-β were assessed at months 0, 6 and 12. Additionally, endothelial function was assessed by use of the brachial artery reactivity technique.

Results: Besides marked reduction in lipid levels, glycated hemoglobin significantly increased from baseline after 12 months in both Group 1 (+0.8 ± 0.2%, p < 0.001) and Group 2 (+0.9 ± 0.3%; p < 0.001). Similar trends were observed for fasting glucose in both groups. No changes in insulin sensitivity were detected throughout the study, whereas HOMA-β significantly decreased from baseline after 12 months in both Group 1 (-21.9%, p < 0.01) and Group 2 (-38.9%; p < 0.001). In addition, both treatments similarly decreased C-reactive protein and leptin, as well as improved endothelial function. No changes in anthropometric measures were observed.

Conclusions: In well-controlled type 2 diabetic patients both rosuvastatin and simvastatin significantly impaired glycemic control and insulin secretion, without affecting insulin sensitivity.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adiponectin / blood
  • Biomarkers / blood
  • Blood Glucose / drug effects*
  • Blood Glucose / metabolism
  • Brachial Artery / drug effects
  • Brachial Artery / metabolism
  • Brachial Artery / physiopathology
  • C-Reactive Protein / metabolism
  • Chi-Square Distribution
  • Cross-Over Studies
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / diagnosis
  • Diabetes Mellitus, Type 2 / drug therapy*
  • Diabetes Mellitus, Type 2 / physiopathology
  • Endothelium, Vascular / drug effects
  • Endothelium, Vascular / metabolism
  • Endothelium, Vascular / physiopathology
  • Female
  • Fluorobenzenes / adverse effects*
  • Glucose Clamp Technique
  • Glycated Hemoglobin A / metabolism
  • Homeostasis
  • Hospitals, University
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / adverse effects*
  • Hypoglycemic Agents / therapeutic use*
  • Insulin / blood*
  • Insulin / metabolism
  • Insulin Resistance*
  • Insulin Secretion
  • Insulin-Secreting Cells / drug effects
  • Insulin-Secreting Cells / metabolism
  • Leptin / blood
  • Lipids / blood
  • Male
  • Middle Aged
  • Pyrimidines / adverse effects*
  • Rome
  • Rosuvastatin Calcium
  • Simvastatin / adverse effects*
  • Single-Blind Method
  • Sulfonamides / adverse effects*
  • Time Factors
  • Treatment Outcome
  • Tumor Necrosis Factor-alpha / blood

Substances

  • ADIPOQ protein, human
  • Adiponectin
  • Biomarkers
  • Blood Glucose
  • Fluorobenzenes
  • Glycated Hemoglobin A
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Hypoglycemic Agents
  • Insulin
  • Leptin
  • Lipids
  • Pyrimidines
  • Sulfonamides
  • Tumor Necrosis Factor-alpha
  • hemoglobin A1c protein, human
  • Rosuvastatin Calcium
  • C-Reactive Protein
  • Simvastatin