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Randomized controlled trials have clearly demonstrated the efficacy of statins in reduction of serum low density lipoprotein cholesterol level by 25-50% from the baseline. Statins may increase the risk of diabetes mellitus (DM) in long-term therapy and use of high doses. Diabetogenic action is statins class effect and does not depend on their hydrophobic or hydrophilic properties. However, the use of statins in patients with DM is obligatory. The statins diabetogenic  risk is exaggerated and we will continue to treat our patients with statins.

About the Author

O. M. Drapkina
I.M. Sechenov First Moscow State Medical University, Moscow
Russian Federation


1. Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA 2001;285(19):2486-24

2. Rizzo M, Berneis K. Low-density lipoprotein size and cardiovascular risk assessment. QJM. 2006;99(1):1-14.

3. Sever PS, Dahlöf B, Poulter NR, et al; ASCOT investigators. Prevention of coronary and stroke events with atorvastatin in hypertensive patients who have average or lower-than-average cholesterol concentrations, in the Anglo-Scandinavian Cardiac Outcomes Trial Lipid Lowering Arm (ASCOT-LLA): a multicentre randomised controlled trial. Lancet 2003;361(9364):1149-58.

4. Ohmura C, Watada H, Hirose T, et al. Acute onset and worsening of diabetes concurrent with administration of statins. Endocr J 2005;52(3):369-72

5. Freeman DJ, Norrie J, Sattar N, et al. Pravastatin and the development of diabetes mellitus: evidence for a protective treatment effect in the West of Scotland Coronary Prevention Study. Circulation 2001;103(3):357-62.

6. Gupta AK, Dahlof B, Dobson J, et al. Anglo-Scandinavian Cardiac Outcomes Trial Investigators. Determinants of new-onset diabetes among 19,257 hypertensive patients randomized in the Anglo-Scandinavian Cardiac Outcomes Trial Blood Pressure Lowering Arm and the relative influence of antihypertensive medication. Diabetes Care 2008;31(5):982-8.

7. Cannon CP, Braunwald E, McCabe CH, et al. Intensive versus Moderate Lipid Lowering with Statins after Acute Coronary Syndromes for the Pravastatin or Atorvastatin Evaluation and Infection Therapy-Thrombolysisin Myocardial Infarction 22 Investigators. N Engl J Med 2004;350(15):1495-504.

8. Kones R. Rosuvastatin, inflammation, C-reactive protein, JUPITER, and primary prevention of cardiovascular disease--a perspective. Drug Des Devel Ther 2010;4:383-413

9. Sasaki J, Iwashita M, Kono S. Statins: beneficial or adverse for glucose metabolism. J Atheroscler Thromb 2006;13(3):123-9.

10. Sukhija R, Prayaga S, Marashdeh M, et al. Effect of statins on fasting plasma glucose in diabetic and nondiabetic patients. J Investig Med 2009;57:495-499

11. Koh KK, Quon MJ, Han SH, et al. Atorvastatin causes insulin resistance and increases ambient glycemia in hypercholesterolemic patients. J Am Coll Cardiol 2010;55:1209-1216

12. Kostapanos MS, Milionis HJ, Agouridis AD, et al. Rosuvastatin treatment is associated with an increase in insulin resistance in hyperlipidaemic patients with impaired fasting glucose. Int J Clin Pract 2009;63:1308-1313

13. Sattar N, Preiss D, Murray HM, et al. Statins and risk of incident diabetes: a collaborative meta-analy- sis of randomised statin trials. Lancet 2010;375(9716):735-42.

14. Baker WL, Talati R, White CM et al. Differing effect of statins on insulin sensitivity in non-diabetics: a systematic review and meta-analysis. Diabetes Res Clin Pract 2010;87(1):98-107.

15. Oldfield E. Targeting Isoprenoid Biosynthesis for Drug Discovery: Bench to Bedside. Acc Chem Res 2010; 43(9): 1216-1226

16. Chamberlain LH. Inhibition of isoprenoid biosynthesis causes insulin resistance in 3T3-L1 adipocytes. FEBS Lett 2001;507(3):357-61.

17. Nakata M, Nagasaka S, Kusaka I et al. Effects of statins on the adipocyte maturation and expression of glucose transporter 4 (SLC2A4): implications in glycaemic control. Diabetologia 2006;49(8): 1881-92.

18. Brozinick JT, Berkemeier BA, Elmendorf JS. “Acting” on GLUT4: Membrane & Cytoskeletal Components of Insulin Action. Curr Diabetes Rev 2007; 3(2): 111-122

19. Koh KK, Quon MJ, Han SH et al. Differential metabolic effects of pravastatin and simvastatin in hypercholesterolemic patients. Atherosclerosis 2009;204(2):483-90.

20. Nathan DM, Buse JB, Davidson MB et al. Medical Management of Hyperglycemia in Type 2 Diabetes: A Consensus Algorithm for the Initiation and Adjustment of Therapy. A consensus statement of the American Diabetes Association and the European Association for the Study of Diabetes. Clinical Diabetes 2009; 27(1): 4-16

21. Devaraj S, Siegel D, Jialal I. Simvastatin (40 mg/day), adiponectin levels, and insulin sensitivity in subects with the metabolic syndrome. Am J Cardiol 2007;100(9):1397-9

22. Yada T, Nakata M, Shiraishi T, Kakei M. Inhibition by simvastatin, but not pravastatin, of glucoseinduced cytosolic Ca2+ signalling and insulin secretion due to blockade of L-type Ca2+ channels in rat islet beta-cells. Br J Pharmacol 1999;126:1205-13

23. NICE clinical guideline 87. Type 2 diabetes: the management of type 2 diabetes. National Institute for Health and Clinical Excellence; 2009. Available at: pdf/cg87niceguideline.pdf. Date of access: 18.08.2013.

For citation:

Drapkina O.M. STATINS AND THE RISK OF DIABETES MELLITUS. Rational Pharmacotherapy in Cardiology. 2013;9(4):444-447. (In Russ.)

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