Statin Treatment in Diabetes Mellitus

Buse, John B.

doi:10.2337/diaclin.21.4.168

Cited by 27 publications

(17 citation statements)

References 19 publications

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“…The more favorable lipid profiles and the use of statin treatment may be one of the factors contributing to the long-term survival of the survivors. In previous studies, statin therapy has been associated with a 19–55% reduction in cardiovascular disease events in patients with diabetes (33). Statins also are known to reduce the rate of progression of microvascular complications, including diabetic retinopathy, nephropathy, and neuropathy (34–36).…”

Section: Discussionmentioning

confidence: 98%

Clinical Profile of Long-Term Survivors and Nonsurvivors With Type 2 Diabetes

et al. 2013

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OBJECTIVETo compare clinical profile of long-term survivors and nonsurvivors with type 2 diabetes (T2DM).RESEARCH DESIGN AND METHODSAfter conducting a retrospective survey of >200,000 case records, we identified T2DM survivors (>40 years of duration) and age at diagnosis and sex-matched T2DM nonsurvivors. Prevalence of complications and causes of death were analyzed. Retinopathy was diagnosed by retinal photography. Microalbuminuria and macroalbuminuria, peripheral vascular disease based on ankle-brachial index <0.9, coronary artery disease based on history of myocardial infarction or coronary revascularization, and neuropathy based on vibration perception threshold >20 V were compared in both groups.RESULTSThe mean duration of diabetes of survivors (n = 238) was 43.7 ± 3.9 years, and that of the nonsurvivors (n = 307), at time of death, was 22.4 ± 11.0 years (P < 0.001). Nonsurvivors had significantly higher systolic and diastolic blood pressures, plasma glucose, HbA1c, serum cholesterol, LDL cholesterol, and triglycerides and lower HDL cholesterol compared with long-term survivors (P < 0.001 for all parameters except systolic blood pressure, which was P = 0.027). Myocardial infarction (46.4%) and renal failure (16.6%) were the most common causes of death. Prevalence of most complications was higher among survivors because of longer duration and older age, as follows, for survivors versus nonsurvivors: retinopathy, 76 vs. 62%; microalbuminuria, 39.1 vs. 27.3%; macroalbuminuria, 8.4 vs. 23.7%; neuropathy, 86.5 vs. 63.5%; peripheral vascular disease, 23.1 vs. 11.4%; and coronary artery disease, 44.5 vs. 40.7%.CONCLUSIONSLong-term survivors with T2DM had better glycemic and blood pressure control and more favorable lipid profiles.

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Section: Discussionmentioning

confidence: 98%

Clinical Profile of Long-Term Survivors and Nonsurvivors With Type 2 Diabetes

et al. 2013

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“…Individuals with type 2 diabetes are at a higher risk for heart disease due to diabetic dyslipidemia, and 60% to 80% of people with diabetes will die of CVD [31]. It has been shown that lipid-lowering medication in this population is associated with a 22% to 24% reduction in major cardiovascular events, and as a result of these findings, in 2004 the American College of Physicians recommended that all individuals with type 2 diabetes over 55 years of age (as well as younger patients with additional risk factors such as high blood pressure) be prescribed a statin to prevent heart disease [32].…”

Section: Diabetesmentioning

confidence: 99%

Statin myopathy: Incidence, risk factors, and pathophysiology

Sewright¹,

Clarkson

Thompson³

2007

Curr Atheroscler Rep

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3-Hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins) are generally well-tolerated lipid-lowering drugs. However, they are associated with myopathy, and incidence rates of muscle-related complaints predicted from clinical trials may underestimate rate of occurrence of these side effects in clinical practice. The development of a standardized system for description and documentation of statin-associated myopathy that includes the entire spectrum of muscle complaints would provide valuable data for researchers and clinicians seeking to better understand statin-induced muscle complaints. Among the risk factors for myopathy are polypharmacy, high-dose statin treatment, aging, and diabetes. The etiology of statin-induced myopathy is not well understood, but potential contributing mechanisms include decreases in mevalonate pathway products, mitochondrial dysfunction, alterations in gene expression related to apoptosis and protein degradation, and genetic predisposition.

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“…In addition to reducing LDL-C concentrations, statins can also decrease TG in some patients, perhaps by reducing the rate of very low density lipoprotein synthesis and increasing its clearance. They also increase apolipoprotein A1 (ApoA1) and HDL-C levels although the mechanisms are unclear 27. In addition, statins are thought to have pleiotropic effects which include improvements in inflammatory responses, endothelial function and smooth muscle proliferation.…”

Section: Mechanism Of Action Metabolism Pharmacokinetic Profile Andmentioning

confidence: 99%

Rosuvastatin and Atorvastatin: Comparative Effects on Glucose Metabolism in Non-Diabetic Patients with Dyslipidaemia

Abbas

Milles

Ramachandran

2012

Clin Med Insights Endocrinol Diabetes

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The ever increasing interventional CVD outcome studies have resulted in statins being an essential factor of cardiovascular prevention strategies. The JUPITER study in 2008, despite reducing CVD and overall mortality, highlighted an increase in new onset diabetes in the rosuvastatin treated arm. Since then there have been many meta-analyses of the RCTs and the largest carried out by Sattar et al showed a significant increase in the incidence of diabetes during the trials. The findings from the individual studies when comparing the different statins were less clear. A higher statin dosage and risk factors associated with diabetes appeared to predict this phenomenon. There have been many studies investigating the effects of statins on glycaemic control, but again no clear conclusion is apparent. Despite the increase in new onset diabetes observed, the risk is clearly out-weighed by the CVD benefits observed in nearly all the statin trials. Thus, no change is required to any of the prevention guidelines regarding statins. However, it may be prudent to monitor glycaemic control after commencing statin therapy. This review will focus on atorvastatin which is the most widely used statin worldwide and rosuvastatin which is the most efficacious. This will be against a background of the effects of other statins on glucose metabolism in non-diabetic patients.

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Statin Treatment in Diabetes Mellitus

Cited by 27 publications

References 19 publications

Clinical Profile of Long-Term Survivors and Nonsurvivors With Type 2 Diabetes

Clinical Profile of Long-Term Survivors and Nonsurvivors With Type 2 Diabetes

Statin myopathy: Incidence, risk factors, and pathophysiology

Rosuvastatin and Atorvastatin: Comparative Effects on Glucose Metabolism in Non-Diabetic Patients with Dyslipidaemia

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