Abstract

Background: Diabetes mellitus (DM) is the most common chronic endocrine disorder worldwide. Statin therapy remains the cornerstone of the primary prevention option for the management of hypercholesterolemia in patients at risk for atherosclerotic cardiovascular disorder. Despite the pivotal role of statin in the management of hypercholesterolemia, several randomized controlled trials, and observational studies have reported that statins worsen glycemia and increase the risk of New-Onset Diabetes Mellitus (NODM). The objective of this study was to validate the potential risk factors of statin-induced NODM in dyslipidemia patients.
Method: Electronic patient records from the King Fahad Hospital of the University, Imam Abdulrahman Bin Faisal University were screened for patients who have been administered statin for more than 1 year. We retrospectively analyzed the factors affecting the development of DM after statin therapy.
Results: Of the 3,562 statin users 150 had incident diabetes with an incidence rate of 4.2% with a relative risk ratio of 1.91 (95% CI: 1.62-2.26). The overall mean age of the study population was 57.72 ± 14.73, and NODM association with older age was seen. Interestingly, 20 mg dose [odds ratio (OR): 7.3; 95% confidence interval (CI): 4.6-11.7] and early users between 1 and 2 years (OR: 37.2; 95% CI: 21.3-65.0) showed a statistically significant effect on NODM.
Conclusion: This hospital-based survey highlights the clinical necessity of performing diabetes screening before initiation of statin therapy. As the risk of NODM increased in the early stages of statin treatment, clinicians should emphasize the need for lifestyle modification and enlighten the new users of statin about the potential benefits and side effects of statin therapy.

Key words: Statins; Diabetes mellitus; Drug-induced diabetes; Atorvastatin; New-onset diabetes mellitus; Treatment risk paradox.