The differences in the incidence of diabetes mellitus and prediabetes according to the type of HMG-CoA reductase inhibitors prescribed in Korean patients

Pharmacoepidemiol Drug Saf. 2017 Oct;26(10):1156-1163. doi: 10.1002/pds.4237. Epub 2017 May 29.

Abstract

Background: Very few studies conducted in Korea have investigated the relationship between statins and the incidence of diabetes. Therefore, we analyzed the progression from normal blood glucose to prediabetes and then to diabetes mellitus (DM) according to the type, intensity, and dose of statin prescribed.

Methods: Data of patients who were first prescribed statins between 2009 and 2011 were extracted from electronic medical records. Patients with normal blood glucose or prediabetes were observed for 4 years after initiation of statin therapy.

Results: A total of 2890 patients were included in our study and analyzed on the basis of the first statin they were prescribed. The incidence rate of DM in patients with prediabetes was 1.72 times that of patients with normal glucose levels (odds ratio = 1.72, 95% confidence interval = 1.41-2.10, P < .001). Regarding progression from normal blood glucose to prediabetes, the incidence rate of prediabetes was significantly lower in patients prescribed pitavastatin (odds ratio = 0.62, 95% confidence interval = 0.40-0.96, P = .031) compared to that in patients prescribed atorvastatin. Regarding the progression from normal blood glucose or prediabetes to DM, there were no significant differences among all statins.

Conclusions: Lower DM incidence in patients prescribed pitavastatin appears to be primarily because of the lower rate of progression from normal blood glucose to prediabetes. These findings indicate that avoiding statins because of DM risk is unjustified and that clinicians should prescribe statins from the appropriate potency group.

Keywords: diabetes mellitus; prediabetes; statin.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Atorvastatin / therapeutic use
  • Blood Glucose / drug effects
  • Diabetes Mellitus / chemically induced
  • Diabetes Mellitus / epidemiology*
  • Disease Progression
  • Electronic Health Records / statistics & numerical data
  • Female
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / adverse effects*
  • Hyperlipidemias / drug therapy*
  • Incidence
  • Male
  • Middle Aged
  • Prediabetic State / chemically induced
  • Prediabetic State / epidemiology*
  • Quinolines / therapeutic use
  • Republic of Korea / epidemiology
  • Retrospective Studies

Substances

  • Blood Glucose
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Quinolines
  • Atorvastatin
  • pitavastatin