Statins associated with development of diabetes mellitus in post-menopausal women

You might remember this post from July of 2011, from a meta-analysis in JAMA showing that the risk of new onset diabetes was higher in the intensive dose group, at 1.12. Now there’s another review from Women’s Health Initiative data suggesting a similar theory. 

The Women’s Health Initiave, oft shortened to WHI, looked at over 161,00 women between 1993 to 1998, and followed up the data for several years, with this analysis going until 2005. It was most famous for highlighting the adverse effects of HRT, from thrombosis to malignancy – and now it’s finding a problem with statins.

The risk at baseline of diabetes mellitus was 1.71, and remained after doing multivariate analysis to exclude for other identified confounders (1.48). It’s certainly interesting – such beneficial pleitropic cardiovascular effects, and yet the possibility to unleash a a major cardiovascular risk factor.

Could you do a randomised controlled trial however? Perhaps in the field of primary prevention, but when it comes to secondary prevention, where the majority of evidence is, ethics approval could be tricky.

It’s worth a read, and may only strengthen the work behind newer cholesterol lowering agents – but could they ever replace the wonder drug?

 

 

 

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2 thoughts on “Statins associated with development of diabetes mellitus in post-menopausal women

  1. thanks for posting this article. was interesting discussion for our study group and will certainly change clinical practice for a few. a lot of postmenopausal women are started on statins for borderline hypercholesterolaemia and continued on low-dose statin therapy lifelong, instead of perhaps re-assessing the levels with short-term treatment and lifestyle change. a good reminder of the importance of medication rationalisation.

    • Thanks for the feedback Jordan. Good article (especially with the previous one) – it will be interesting to see whether this will change practice or not. Statins have such a powerful influence, and despite these few studies, they haven’t permeated into the guidelines…yet.

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