title: Statins are independently associated with increased HbA1c in type 1 diabetes--The Thousand & 1 Study.
abstract: OBJECTIVE
  Statin use has been associated with increased risk of developing type 2 diabetes (T2DM), and with impaired glycemic control in T2DM patients. The association between statin use and glycemic control in type 1 diabetes (T1DM) is unknown. The association between use of statins and glycemic control in T1DM patients without known heart disease was examined.
  
  
  METHODS
  Cross-sectional study of 1093 T1DM patients from the outpatient clinic at Steno Diabetes Center. Physical examination, questionnaires, and echocardiography were performed in all patients. Investigators were blinded to all laboratory measurements. Data were analyzed in uni-and multivariable models.
  
  
  RESULTS
  Mean age 49.6 years, 53% men, mean diabetes duration 25.5 years, 475 (43.5%) received statins. In baseline analyses statin users tended to be older, have longer diabetes duration, and have more severe kidney disease. Left ventricular ejection fraction was not associated with statin use. In multivariable models including age, gender, diabetes duration, BMI, blood pressure, physical activity, family history of cardiovascular disease, physical activity, albuminuria, eGFR, retinopathy, smoking, cholesterol, ejection fraction, triglycerides, and use of ACE/ATII-antagonists, aspirin, calcium-antagonists, betablockers or diuretics, statin use was independently and significantly associated with higher HbA1c (0.2% (95%CI: 0.1; 0.4) (2.0 mmol/mol (0.2; 3.8)), p=0.029).
  
  
  CONCLUSIONS
  In T1DM, use of statins is independently associated with impaired glycemic control. A causal relationship cannot be determined from this study. Given the benefit on cardiovascular outcome, this should not cause patients to stop statin treatment, but may indicate a need to revisit dose of insulin when starting statin treatment.
authors.affiliation: Department of Internal Medicine, Holbaek Hospital, Smedelundsgade 60, 4300 Holbæk, Denmark; Department of Cardiology, Copenhagen University Hospital Gentofte, Kildegårdsvej 28, 2900 Hellerup, Denmark; Steno Diabetes Center, Niels Steensens Vej 2, 2820 Gentofte, Denmark. Electronic address: magnustjensen@gmail.com.
authors.forename: Magnus Thorsten
authors.initials: MT
authors.lastname: Jensen
authors.affiliation: Steno Diabetes Center, Niels Steensens Vej 2, 2820 Gentofte, Denmark.
authors.forename: Henrik Ullits
authors.initials: HU
authors.lastname: Andersen
authors.affiliation: Steno Diabetes Center, Niels Steensens Vej 2, 2820 Gentofte, Denmark; Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health Sciences University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen N, Denmark; Faculty of Health, University of Aarhus, Nordre Ringgade 1, 8000 Aarhus C, Denmark.
authors.forename: Peter
authors.initials: P
authors.lastname: Rossing
authors.affiliation: Department of Cardiology, Copenhagen University Hospital Gentofte, Kildegårdsvej 28, 2900 Hellerup, Denmark; Institute of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen N, Denmark.
authors.forename: Jan Skov
authors.initials: JS
authors.lastname: Jensen
mesh_terms: D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000032:analysis / Q000187:drug effects; D002318:Cardiovascular Diseases / Q000097:blood / Q000150:complications / Q000000981:diagnostic imaging / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003718:Denmark / Q000453:epidemiology; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology*; D004452:Echocardiography; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis* / Q000187:drug effects; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D006937:Hypercholesterolemia / Q000097:blood / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology; D007328:Insulin / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D016277:Ventricular Function, Left / Q000502:physiology
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D007328:Insulin; C517652:hemoglobin A1c protein, human
keywords: Diabetes; Glycemic control; HbA1c; Prevention; Statins; Type 1 diabetes