title: Risk of incident diabetes among patients treated with statins: population based study.
abstract: OBJECTIVE
  To examine the risk of new onset diabetes among patients treated with different HMG-CoA reductase inhibitors (statins).
  
  
  METHODS
  Population based cohort study with time to event analyses to estimate the relation between use of particular statins and incident diabetes. Hazard ratios were calculated to determine the effect of dose and type of statin on the risk of incident diabetes.
  
  
  METHODS
  Ontario, Canada.
  
  
  METHODS
  All patients aged 66 or older without diabetes who started treatment with statins from 1 August 1997 to 31 March 2010. The analysis was restricted to new users who had not been prescribed a statin in at least the preceding year. Patients with established diabetes before the start of treatment were excluded.
  
  
  METHODS
  Treatment with statins.
  
  
  METHODS
  Incident diabetes.
  
  
  RESULTS
  Compared with pravastatin (the reference drug in all analyses), there was an increased risk of incident diabetes with atorvastatin (adjusted hazard ratio 1.22, 95% confidence interval 1.15 to 1.29), rosuvastatin (1.18, 1.10 to 1.26), and simvastatin (1.10, 1.04 to 1.17). There was no significantly increased risk among people who received fluvastatin (0.95, 0.81 to 1.11) or lovastatin (0.99, 0.86 to 1.14). The absolute risk for incident diabetes was about 31 and 34 events per 1000 person years for atorvastatin and rosuvastatin, respectively. There was a slightly higher [corrected] absolute risk with simvastatin (26 outcomes per 1000 person years) compared with pravastatin (23 outcomes per 1000 person years). Our findings were consistent regardless of whether statins were used for primary or secondary prevention of cardiovascular disease. Although similar results were observed when statins were grouped by potency, the risk of incident diabetes associated with use of rosuvastatin became non-significant (adjusted hazard ratio 1.01, 0.94 to 1.09) when dose was taken into account.
  
  
  CONCLUSIONS
  Compared with pravastatin, treatment with higher potency statins, especially atorvastatin and simvastatin, might be associated with an increased risk of new onset diabetes.
authors.affiliation: Toronto General Hospital, Toronto, ON, Canada M5G 2C4.
authors.forename: Aleesa A
authors.initials: AA
authors.lastname: Carter
authors.forename: Tara
authors.initials: T
authors.lastname: Gomes
authors.forename: Ximena
authors.initials: X
authors.lastname: Camacho
authors.forename: David N
authors.initials: DN
authors.lastname: Juurlink
authors.forename: Baiju R
authors.initials: BR
authors.lastname: Shah
authors.forename: Muhammad M
authors.initials: MM
authors.lastname: Mamdani
mesh_terms: D000368:Aged; D000069059:Atorvastatin; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000517:prevention & control*; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000139:chemically induced* / Q000453:epidemiology / Q000209:etiology; D004305:Dose-Response Relationship, Drug; D050171:Dyslipidemias / Q000188:drug therapy* / Q000453:epidemiology; D005260:Female; D005464:Fluorobenzenes / Q000008:administration & dosage / Q000009:adverse effects; D006538:Heptanoic Acids / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects*; D015994:Incidence; D008297:Male; D016017:Odds Ratio; D009864:Ontario / Q000453:epidemiology; D011159:Population Surveillance; D017035:Pravastatin / Q000008:administration & dosage / Q000009:adverse effects; D016016:Proportional Hazards Models; D011743:Pyrimidines / Q000008:administration & dosage / Q000009:adverse effects; D011758:Pyrroles / Q000008:administration & dosage / Q000009:adverse effects; D012189:Retrospective Studies; D000068718:Rosuvastatin Calcium; D019821:Simvastatin / Q000008:administration & dosage / Q000009:adverse effects; D013449:Sulfonamides / Q000008:administration & dosage / Q000009:adverse effects; D016896:Treatment Outcome
chemical_list: D005464:Fluorobenzenes; D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011743:Pyrimidines; D011758:Pyrroles; D013449:Sulfonamides; D000068718:Rosuvastatin Calcium; D000069059:Atorvastatin; D019821:Simvastatin; D017035:Pravastatin