Saturday, May 25, 2013


BMJ 2013. 346 reported a study by Dr Aleesa carter and group from Ontario, Canada. They looked into the Canadian Institute of Health Information database, and the Discharge Abstract database, and also the Ontario Diabetes Database from Aug 1997 - March 2012, over 14 years. From the first two databases, they identified patients above age 66 yrs who were started on statins either for primary prevention or secondary prevention. From the third database, they identified those who were not diabetic before but over the followup period, developed diabetes.
Using this protocol, they found that there was an increase incidence of new onset diabetes with the use of potent statins. Potent either in the type of statins, like Atorvastatin, Rosuvastatin, and simvastatin.

Looks like the use of mild statins, like pravastatin and lovastatin, was not associated with this risk.
They calculated that there was 1 new case of new onset diabetes for every 160 new patients started on atorvastatin. I think that this is significant. Thinking back, I must have given a few of my patients new onset diabetes, over the many years of cardiac practice. Atorvastatin came to us in the 90s.
Having said all that, we still maintain that statins does more good then harm. The benefit from secondary prevention of CAD with statins far outweighs the risk of new onset diabetes, and statins will continue to be used. It does more good than harm.
However, I may have to watch my patients on the " super statins" closer for new onset diabetes, and have them on a low carb diet as well, in an attempt to prevent new onset diabetes.

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