title: Risk of new-onset diabetes associated with statin use.
abstract: OBJECTIVE
  To identify and assess studies investigating the association between statins and new-onset diabetes and determine the clinical significance of this risk.
  
  
  METHODS
  A MEDLINE (1977-April 2015), Google Scholar (1997-April 2015), and International Pharmaceutical Abstracts (1977-April 2015) search was performed using the search terms hydroxymethylglutaryl-CoA reductase inhibitors, hydroxymethylglutaryl-CoA reductase inhibitors/adverse effects, statins, adverse effects, diabetes mellitus, diabetes mellitus/etiology, and drug-induced. Citations of identified articles and clinical practice guidelines were also reviewed.
  
  
  METHODS
  Articles describing results from original investigations or meta-analyses specifically designed to assess the association between statins and new-onset diabetes and published in English were included.
  
  
  RESULTS
  A total of 13 cohort studies and seven meta-analyses were included. In all, 11 were retrospective cohort studies and reported some degree of increased risk of new-onset diabetes associated with statins. The two prospective cohort studies differed. One identified increased risk of new-onset diabetes, but the other did not. Increased risk was not identified when any statin was compared to placebo alone, individual statins were compared, or in the single meta-analysis that included observational studies. Overall, the meta-analyses suggest that statin therapy is associated with an increased risk of new-onset diabetes when compared to placebo or active control, and when intensive therapy is compared to moderate therapy.
  
  
  CONCLUSIONS
  Statins have been associated with a small, but statistically significant risk of new-onset diabetes. Patients with risk factors for developing diabetes mellitus may be at higher risk. This risk is likely outweighed by the benefits of reducing cardiovascular risk.
authors.affiliation: Manchester University College of Pharmacy, Fort Wayne, IN, USA.
authors.forename: Robert D
authors.initials: RD
authors.lastname: Beckett
authors.affiliation: Parkview Regional Medical Center, Fort Wayne, IN, USA.
authors.forename: Sarah M
authors.initials: SM
authors.lastname: Schepers
authors.affiliation: Manchester University College of Pharmacy, Fort Wayne, IN, USA.
authors.forename: Sarah K
authors.initials: SK
authors.lastname: Gordon
keywords: HMG-CoA reductase inhibitors; drug-induced diseases; new-onset diabetes