title: Use of statins and the incidence of type 2 diabetes mellitus.
abstract: BACKGROUND
  the use of statins is associated with reduced cardiovascular risk in studies of primary and secondary prevention, and the reduction is directly proportional to the reduction of LDL-cholesterol. Recent evidence suggests that statins may be associated with a higher incidence of new cases of diabetes. The aim of this review is to explore this possibility, identifying factors associated with the increase in risk and the potential diabetogenic mechanisms of statins. In addition, we evaluated if the risk of diabetes interferes with the reduction in cardiovascular risk achieved with statins.
  
  
  METHODS
  we reviewed articles published in the Scielo and Pubmed databases, which assessed or described the association between use of statins and risk of diabetes up to June 2015.
  
  
  RESULTS
  use of statins is associated with a small increase in the incidence of new cases of diabetes. Age, potency of statin therapy, presence of metabolic syndrome, impaired fasting blood glucose, overweight and previously altered glycated hemoglobin levels are associated with increased risk of diabetes, but there is no consensus about the possible diabetogenic mechanisms of statins. In patients candidate to hypolipemiant drug therapy, the benefit of reducing cardiovascular risk outweighs any risk increase in the incidence of diabetes.
  
  
  CONCLUSIONS
  statins are associated with a small increase in incidence of diabetes in patients predisposed to glycemic alteration. However, since the benefit of cardiovascular risk reduction prevails even in this group, there is no evidence to date that this finding should change the recommendation of starting statin therapy.
authors.affiliation: Centro de Epidemiologia e Pesquisa Clínica, Escola de Medicina, Pontifícia Universidade Católica do Paraná, Curitiba, PR, BR.
authors.forename: André
authors.initials: A
authors.lastname: Bernardi
authors.affiliation: Instituto do Coração, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, BR.
authors.forename: Viviane Zorzanelli
authors.initials: VZ
authors.lastname: Rocha
authors.affiliation: Centro de Epidemiologia e Pesquisa Clínica, Escola de Medicina, Pontifícia Universidade Católica do Paraná, Curitiba, PR, BR.
authors.forename: José Rocha
authors.initials: JR
authors.lastname: Faria-Neto
mesh_terms: 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* / Q000378:metabolism; D015994:Incidence; D018570:Risk Assessment
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors