Impact of Statin Therapy on the Development of New-Onset Diabetes in Cardiovascular Patients

Background: The initial pharmacological intervention for hypercholesterolemia in individuals at risk for atherosclerotic cardiovascular disease (CVD) commonly involves statins. Data from contemporary randomized controlled trials (RCTs) and observational studies indicate an increased risk of new-onset diabetes mellitus (NODM) associated with statin therapy, particularly with high-intensity statins that achieve a 50% or greater reduction in low-density lipoprotein cholesterol (LDL-C), with this risk manifesting early in the treatment course. Objective: This study aimed to provide a comprehensive review of results from both RCTs and observational studies to examine the association between statin use and the incidence of NODM. It puts this information in perspective by contrasting it with proven advantages of statin medication in lowering the risk of CVD. Findings: The elevation in NODM risk connected to statin therapy seems to be primarily associated with individuals with major NODM risk factors, according to RCTs. Intensive statin therapy increases the incidence of NODM in individuals at high risk by approximately 25% compared to placebo, and intensive statin therapy increases the incidence by around the same amount as moderate-intensity statin therapy. Conclusion: Despite this, in patients with major NODM risk factors, the proportion of CVD events averted per excess NODM case is nearly or more than one. This implies a robust risk-benefit ratio favoring the continuation of aggressive statin treatment for patients highly susceptible to CVD, aligning with current guidelines for cholesterol-lowering medication.