Endocrine Abstracts

Background: Statin medication is commonly used in prevention of cardiovascular diseases. Pooled evidence shows that statin therapy is associated with increased risk of incident diabetes, but studies vary in results and there is no consensus of the diabetogenic mechanism of statins. Beta blockers and diuretics are commonly used antihypertensive agents that also have been shown to increase the risk of incident diabetes. Our objective was to examine the effects of statins, beta blockers and diuretics on glucose metabolism and the risk of incident diabetes.

Methods: 5208 subjects from western Finland identified through the Population registry participated in the baseline PPP-Botnia Study, and 3,614 subjects participated in the follow-up study after a mean time of 6.7 years. Participants underwent oral glucose tolerance tests (OGTT) and gave information about their use of medication. Insulinogenic index (IGI) and corrected insulin response (CIR) were calculated from the glucose and insulin response during OGTT.

Results: After controlling for confounding factors, the group treated with statins during the entire follow-up had a, nominally significant, 79% (95% CI 1.16, 2.76 P=0.008) increased risk of developing incident diabetes, compared to the group without statins, and statin use was significantly associated with higher levels of fasting plasma glucose (FPG) and 2 hour plasma glucose (2hPG). Statin therapy was associated with a reduced CIR30, but not IGI30. Beta blocker therapy was associated with a nominally significant 63% increased risk of developing incident diabetes.

Conclusion: Statin treatment is associated with an increased risk of incident diabetes, higher levels of FPG and 2hPG, and reduced insulin secretion. Beta blocker therapy is associated with an increased risk of incident diabetes.