(29-08-14) Statins and the Risk of Diabetes: Evidence From a Large Population-Based Cohort Study

Giovanni Corrao1⇑, Buthaina Ibrahim1, Federica Nicotra1,Davide Soranna1, Luca Merlino2,
Alberico L. Catapano3,4, Elena Tragni3,Manuela Casula3, Guido Grassi4,5 and Giuseppe Mancia5,6
+Author Affiliations
1Department of Statistics and Quantitative Methods, Division of Biostatistics, Epidemiology and Public Health, University of Milano-Bicocca, Milan, Italy
2Operative Unit of Territorial Health Services, Region Lombardia, Milan, Italy
3Department of Pharmacological and Biomolecular Sciences, Centre of Epidemiology and Preventive Pharmacology (SEFAP), University of Milano, Milan, Italy
4IRCCS Multimedica, Sesto San Giovanni, Milan, Italy
5Department of Health Science, University of Milano-Bicocca, Milan, Italy
6IRCCS Istituto Auxologico Italiano, Milan, Italy
Corresponding author: Giovanni Corrao, [email protected].
Abstract
OBJECTIVE To investigate the relationship between adherence with statin therapy and the risk of developing diabetes.
METHODS The cohort comprised 115,709 residents of the Italian Lombardy region who were newly treated with statins during 2003 and 2004. Patients were followed from the index prescription until 2010. During this period, patients who began therapy with an antidiabetic agent or were hospitalized for a main diagnosis of type 2 diabetes were identified (outcome). Adherence was measured by the proportion of days covered (PDC) with statins (exposure). A proportional hazards model was fitted to estimate hazard ratios (HRs) and 95% CIs for the exposure-outcome association, after adjusting for several covariates. A set of sensitivity analyses was performed to account for sources of systematic uncertainty.
RESULTS During follow-up, 11,154 cohort members experienced the outcome. Compared with patients with very-low adherence (PDC <25%), those with low (26¨C50%), intermediate (51¨C75%), and high (¡Ý75%) adherence to statin therapy had HRs (95% CIs) of 1.12 (1.06¨C1.18), 1.22 (1.14¨C1.27), and 1.32 (1.26¨C1.39), respectively.
CONCLUSIONS In a real-world setting, the risk of new-onset diabetes rises as adherence with statin therapy increases. Benefits of statins in reducing cardiovascular events clearly overwhelm the diabetes risk.
Received September 19, 2013.
Accepted April 16, 2014.


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