title: Statins and their increased risk of inducing diabetes.
abstract: BACKGROUND
  Statins are evidence-based drugs to prevent cardiovascular (CV) disease. However, their benefits have been disputed by a statin-related increased risk of new onset diabetes (NOD) in randomized controlled trials and meta-analyses.
  
  
  METHODS
  This review provides an update based on recent outstanding evidence on the statin effect on the risk of diabetes. It also describes mechanisms potentially explaining adverse effects of statins on glucose homeostasis. PubMed was searched for original articles and reviews published from January 2010 (inclusive) to May 2015 (inclusive), which include the Search terms statins, diabetes, glucose, and insulin. NOD risk seems to be more relevant with high-intensity rather than with low-intensity statin treatment. Also, this risk is particularly increased in patients at risk for the development of diabetes. It appears that statins adversely affect glucose homeostasis in parallel with their 3-hydroxy-3-methylglutaryl-coenzyme A inhibition capacity. It was suggested that lipophilic statins are more diabetogenic than the hydrophilic ones. Mechanisms explaining statin diabetogeneicity include impaired insulin secretion by pancreatic β cells together with increased insulin resistance of various tissues.
  
  
  CONCLUSIONS
  The CV outcome benefits from statin use outweigh the diabetes menace. However, patients at risk for the development of diabetes should be prescribed statins with caution.
authors.affiliation: a 1 Department of Clinical Biochemistry (Vascular Disease Prevention Clinics), Royal Free London Foundation Trust , Pond Street, London, UK.|b 2 University of Ioannina, Department of Internal Medicine, Medical School , GR 45110 Ioannina, Greece +30 26 51 00 75 09 ; +30 26 51 00 70 16 ; egepi@cc.uoi.gr.
authors.forename: Aris P
authors.initials: AP
authors.lastname: Agouridis
authors.affiliation: c 3 Cambridge University Hospitals NHS Foundation Trust, Clinical Pharmacology Unit, Addenbrooke's Hospital , Cambridge, UK.
authors.forename: Michael S
authors.initials: MS
authors.lastname: Kostapanos
authors.affiliation: b 2 University of Ioannina, Department of Internal Medicine, Medical School , GR 45110 Ioannina, Greece +30 26 51 00 75 09 ; +30 26 51 00 70 16 ; egepi@cc.uoi.gr.
authors.forename: Moses S
authors.initials: MS
authors.lastname: Elisaf
mesh_terms: D000818:Animals; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D003924:Diabetes Mellitus, Type 2 / Q000139:chemically induced* / Q000453:epidemiology; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D007328:Insulin / Q000378:metabolism; D007333:Insulin Resistance; D000078790:Insulin Secretion; D016032:Randomized Controlled Trials as Topic; D012306:Risk
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D007328:Insulin
keywords: cardiovascular disease; new onset diabetes; statin