Analysis of Glycemic status in Diabetes naïve patients on Statins- a Hospital based Cross Sectional study

[Speaker] Sereen Rose Thomson:1
[Co-author] Bharti Chogtu Magazine:1, Ranjan Shetty:2, Tom Devasia:3
1:Department of Pharmacology, Kasturba Medical College, Manipal, Karnataka, India, 2:Consultant Cardiologist, Department of Cardiology, Manipa hospital, Bangalore, India, 3:Department of Cardiology, Kasturba medical college, Manipal, Karnataka, India

The US FDA in 2012 added a safety label to statin use indicating an increase in blood sugar levels following which hyperglycemia with statins is being viewed with renewed interest globally. Hence, in the present study, the possible diabetogenic effect of statins, the mechanism of this effect and various comorbidities associated with this causation has been explored.
To study the outcome of statin use on plasma glucose levels in patients, with no prior history of hyperglycemia and to analyze the outcome of statins on beta cell functioning and insulin resistance using Homeostatic Model Assessment (HOMA) and Quantitative Insulin Sensitivity Check Index (QUICKI).
A cross-sectional study was carried out at the Department of Cardiology from October 2015-March 2017. Non-diabetic patients on statins for at least 1 year were recruited in the study. Outcome of the study was development of new onset diabetes mellitus (NODM). Mechanism of insulin resistance was obtained by HOMA and QUICKI models. Additional side effect profile and comorbidities associated with this causation was also extracted from the patients. Categorical variables were expressed as percentages and skewed data as median and interquartile range.
A total of 104 patients met the inclusion criteria, of which twelve patients (11.5%) developed NODM within a median time of 4 years. Majority of the patients were males and received atorvastatin 40mg. Comorbidities among our patients were hypertension, hypercholesterolemia, and obesity. The chance of development of NODM with atorvastatin 20 mg, 40 mg, and 80mg were 4.1%, 14.7%, and 25% respectively.83.3% of patients in the study population who developed diabetes had a HOMA score of >2.27 and QUICKI score of <0.357 which is considered as severe insulin resistance. Thirty-three patients developed adverse drug reaction, out of which the maximum reported ADR was myalgia (48.4%) followed by tingling sensation (21.21%)and hepatitis (3.03%).
Even though statins have a mild-moderate risk of developing NODM, the benefit of preventing serious cardiovascular events seems to outweigh the risk of developing diabetes. Hence, statins should be prescribed carefully while monitoring the blood glucose levels in patients at risk for diabetes mellitus.
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