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Effects of High-Intensity Statins on Glucose Homeostasis in Patients with Type 2 Diabetes

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Statin use has been reported to increase the risk of new onset diabetes, and potentially worsen glycemic control in patients with type 2 diabetes (T2D). The risk of new onset… Click to show full abstract

Statin use has been reported to increase the risk of new onset diabetes, and potentially worsen glycemic control in patients with type 2 diabetes (T2D). The risk of new onset diabetes from statin is higher with increased dose of statin administration. This study was aimed to evaluate the effects of high-intensity statins as compared to the lower intensity statins on glucose homeostasis and glycemic control in patients with T2D. T2D who were taking simvastatin up to 20 mg/day (N=100) were randomized to continue using the same dosage of simvastatin (low- to moderate-intensity statin group; LS) for 12 weeks or change to atorvastatin 40 mg/day for 6 weeks and if tolerable increased to atorvastatin 80 mg/day for 6 weeks (high-intensity statin group; HS). Fasting plasma glucose (FPG), HbA1c, fasting plasma insulin, HOMA-IR and HOMA-B were assessed at baseline, 6 weeks and 12 weeks. Oral hypoglycemic agents were unchanged throughout the study period and patients who were on human insulin were excluded from the analysis. Ninety-eight patients completed the study (73% female), mean age 58.9±9.6 years, mean BMI 27.3±4.5 kg/m2, median duration of diabetes was 102 (48-180) months. Mean baseline FPG and HbA1c were 130.4±35.3 mg/dl and 6.9±0.9%, respectively. Median baseline insulin level, HOMA-IR, and HOMA-B were 10.8 (7.5-17.7) mIU/L, 3.3 (2.2-5.5), and 65.5 (37.7-113.8), respectively. There was no significant difference in baseline characteristic and baseline glucose homeostasis parameters between the LS (n=49) and HS group (n=51). There was a slight increase in HbA1c in the HS group as compared to the LS group at 6 weeks (+0.1% vs. 0%, p=0.05), and 12 weeks (+0.1% vs. -0.1%, p=0.13) respectively. However; there were no significant changes in FPG, fasting plasma insulin, HOMA-IR and HOMA-B between the LS and HS group. In conclusion, there was no significant deterioration in glucose homeostasis with high-intensity statins as compared to low dose statins in patients with T2D. Disclosure N. Thongtang: Other Relationship; Self; Pfizer Inc.. S. Sriussadaporn: None. N. Tangkittikasem: None.

Keywords: intensity statins; glucose homeostasis; homa; group; intensity; high intensity

Journal Title: Diabetes
Year Published: 2018

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