Management of statin-induced diabetes

Statins are the most widely used lipid-lowering drugs, due to their proven efficacy to reduce cardiovascular events. Recent post-hoc analyses of randomized controlled trials demonstrated that statins are associated with an increased risk of developing type 2 diabetes (T2D). This association was further confirmed in observational cohorts and Mendelian randomization studies. The risk is higher with high doses of statins and in people with preexisting risk factors for T2D. The underlying molecular mechanisms sustaining the diabetogenic action of statins remains largely unknown. From a clinical perspective, evidence suggests that the benefits of statins for the reduction of cardiovascular risk far outweigh the risk of developing T2D, especially in patients with higher cardiovascular risk. However, physicians should assess all patients for their T2D risk prior to starting statin therapy, in order to reinforce lifestyle changes and to monitor glycaemic parameters.