Incidence of New-Onset Diabetes Mellitus (NODM) Among Patients Using Statins: A Systematic review

Abstract

Background: The utilization of statins is essential for managing dyslipidemia and reducing cardiovascular risk. However, recent studies suggest a potential correlation between statin treatment and new-onset diabetes mellitus (NODM). Understanding the extent of this risk is critical for guiding clinical decision-making and patient care.

Objectives: To systematically review the incidence of NODM among patients using statins and explore the factors influencing this risk, such as statin potency and dosage.

Materials and methods: A systematic search has been performed across Google scholar, PubMed, and Web of Science for studies published between 2010 and 2023. Eligible studies included retrospective and prospective cohort investigations, observational investigations, and case-control investigations that reported the frequency of new-onset diabetes mellitus in adult cases without prior diabetes giving statin treatment. Data on sample size, statin types, follow-up duration, and NODM incidence were extracted and analyzed.

Results: Six investigations with a combined sample size exceeding 143,000 cases have been involved. The incidence of NODM ranged from 6.4% to 10% across studies. High-potency and high-intensity statins were correlated with a higher risk of new-onset diabetes mellitus compared to moderate-intensity statins. In one study, the adjusted hazard ratio for NODM was 2.18 (95% confidence interval, 1.10–4.51) for patients having high-intensity statins than moderate-intensity statins. However, another study found insignificant variance in the incidence of NODM among high-dose atorvastatin and rosuvastatin groups (P = 0.550).

Conclusion: Statin use, particularly at high intensity or potency, is correlated with an elevated risk of NODM. In spite of this risk, the cardiovascular benefits of statins outweigh the potential metabolic side effects for most patients. Personalized treatment strategies, including dose adjustments and regular glucose monitoring, are recommended for high-risk individuals.