Three recent trials comparing intensive- to moderate-dose statin therapy have suggested an increased risk of incident diabetes in patients treated with high-dose statin regimens.  To investigate this phenomenon further, the authors conducted a collaborative meta-anlysis of published and unpublished data from five statin trials, all of which were randomise controlled end-point trials that compared intensive-dose statin therapy with moderate-dose therapy for more than one year.

In these trials, 32,752 patients did not have diabetes at baseline, however 2,7490 developed it: 1449 assigned to intensive-dose therapy, and 1300 assigned to moderate-dose therapy, representing 2.0 additional cases in the intensive-dose group per 1000 patient-years.  Odds ratios were 1.12 for new onset diabetes and 0.84 for cardiovascular events for patients receiving intensive statin therapy compared to those taking moderate-dose therapy.

Conclusions:

In this analysis of 5 statin trials, intensive-dose statin therapy was associated with an increased risk of new-onset diabetes.  Currently, the mechanism of this remains uncertain.

• Preiss D, Seshasai SRK, Welsh P et al.  Risk of Incident Diabetes With Intensive-Dose Compared With Moderate-Dose Statin Therapy.  JAMA 2011;305:2556-2564.