Deterioration of glucose homeostasis in type 2 diabetic patients one year after beginning of statins therapy.
OBJECTIVE
We evaluated the long-term effects of rosuvastatin and simvastatin on insulin sensitivity and secretion in patients with well-controlled type 2 diabetes.


METHODS
After a 3 weeks run-in, 27 eligible patients were randomly assigned to receive either rosuvastatin 20 mg daily (Group 1) or simvastatin 20 mg daily (Group 2) for 6 months; thereafter they were switched to the other treatment for additional 6 months. Patients were recruited among individuals attending the outpatient service of the Diabetology Unit of the "Policlinico Tor Vergata" University Hospital, Rome, Italy. Serum lipids, glucose and insulin, glycated hemoglobin, C-reactive protein, TNF-α, leptin, adiponectin, insulin sensitivity by euglycemic-hyperinsulinemic clamp, β-cells function by HOMA-β were assessed at months 0, 6 and 12. Additionally, endothelial function was assessed by use of the brachial artery reactivity technique.


RESULTS
Besides marked reduction in lipid levels, glycated hemoglobin significantly increased from baseline after 12 months in both Group 1 (+0.8 ± 0.2%, p < 0.001) and Group 2 (+0.9 ± 0.3%; p < 0.001). Similar trends were observed for fasting glucose in both groups. No changes in insulin sensitivity were detected throughout the study, whereas HOMA-β significantly decreased from baseline after 12 months in both Group 1 (-21.9%, p < 0.01) and Group 2 (-38.9%; p < 0.001). In addition, both treatments similarly decreased C-reactive protein and leptin, as well as improved endothelial function. No changes in anthropometric measures were observed.


CONCLUSIONS
In well-controlled type 2 diabetic patients both rosuvastatin and simvastatin significantly impaired glycemic control and insulin secretion, without affecting insulin sensitivity.
Department of Internal Medicine, University "Tor Vergata", Rome, Italy.
Alfonso
A
Bellia
Stefano
S
Rizza
Marco Felice
MF
Lombardo
Giulia
G
Donadel
Rossella
R
Fabiano
Katia
K
Andreadi
Michael J
MJ
Quon
Paolo
P
Sbraccia
Massimo
M
Federici
Manfredi
M
Tesauro
Carmine
C
Cardillo
Davide
D
Lauro
D052242:Adiponectin / Q000097:blood; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000187:drug effects* / Q000378:metabolism; D001916:Brachial Artery / Q000187:drug effects / Q000378:metabolism / Q000503:physiopathology; D002097:C-Reactive Protein / Q000378:metabolism; D016009:Chi-Square Distribution; D018592:Cross-Over Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D004730:Endothelium, Vascular / Q000187:drug effects / Q000378:metabolism / Q000503:physiopathology; D005260:Female; D005464:Fluorobenzenes / Q000009:adverse effects*; D015309:Glucose Clamp Technique; D006442:Glycated Hemoglobin / Q000378:metabolism; D006706:Homeostasis; D006785:Hospitals, University; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects*; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000097:blood* / Q000378:metabolism; D007333:Insulin Resistance; D000078790:Insulin Secretion; D050417:Insulin-Secreting Cells / Q000187:drug effects / Q000378:metabolism; D020738:Leptin / Q000097:blood; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D011743:Pyrimidines / Q000009:adverse effects*; D012384:Rome; D000068718:Rosuvastatin Calcium; D019821:Simvastatin / Q000009:adverse effects*; D016037:Single-Blind Method; D013449:Sulfonamides / Q000009:adverse effects*; D013997:Time Factors; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
D052242:Adiponectin; D015415:Biomarkers; D001786:Blood Glucose; D002097:C-Reactive Protein; D005464:Fluorobenzenes; D006442:Glycated Hemoglobin; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D007004:Hypoglycemic Agents; D007328:Insulin; D020738:Leptin; D008055:Lipids; D011743:Pyrimidines; D000068718:Rosuvastatin Calcium; D019821:Simvastatin; D013449:Sulfonamides; D014409:Tumor Necrosis Factor-alpha; C499918:ADIPOQ protein, human; C517652:hemoglobin A1c protein, human