Longitudinal trends and predictors of statin use among patients with diabetes

J Diabetes Complications. 2018 Jan;32(1):27-33. doi: 10.1016/j.jdiacomp.2017.09.014. Epub 2017 Sep 25.


Aim: Statins reduce morbidity and mortality among patients with diabetes, but their use remains suboptimal. Understanding trends in statin use may inform strategies for improvement.

Methods: We enrolled a national, retrospective cohort of 899,664 veterans aged≥40years with diabetes in 2003. We followed them through 2011, dividing the nine-year follow-up into 90-day periods. For each period, we determined statin use, defined as possession of ≥30-day supply. We examine factors associated with statin uptake among baseline non-users with a multivariate model.

Results: Baseline prevalence of statin use was 43%, increased by 1.8% per period (p for trend<0.001), and reached a maximum of ~59%. Statin use among non-Hispanic racial/ethnic minorities lagged behind their white counterparts. Among baseline non-users, statin use was 9% after Year 1 and reached 36% by Year 9. Factors associated with statin uptake included use of hypoglycemic agents, HbA1c between 7 and 8.9% (53-74mmol/mol), hypertension, heart failure, peripheral vascular disease, and Hispanic ethnicity.

Conclusion: Statin use is slowly increasing among patients with diabetes, and at varying rates within subgroups of this population. Policies that prioritize these subgroups for statin promotion may help guide future, intervention-based research to increase compliance with current guidelines.

Keywords: Cholesterol treatment guidelines; Diabetes; HMG-CoA reductase inhibitors; Racial disparities; Temporal trends.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Aged
  • Cardiovascular Diseases / drug therapy
  • Cardiovascular Diseases / epidemiology
  • Comorbidity
  • Diabetes Mellitus / drug therapy*
  • Diabetes Mellitus / epidemiology*
  • Diabetic Angiopathies / drug therapy
  • Diabetic Angiopathies / epidemiology
  • Ethnicity / statistics & numerical data
  • Female
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use*
  • Hypercholesterolemia / drug therapy
  • Hypercholesterolemia / epidemiology
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Prevalence
  • Racial Groups / statistics & numerical data
  • Retrospective Studies
  • Risk Factors


  • Hydroxymethylglutaryl-CoA Reductase Inhibitors