title: Lower and higher-potency statins on glycemic control in type 2 diabetes: A retrospective cohort study.
abstract: OBJECTIVE
  Evidences showed a link between statins and new-onset diabetes and large clinical trials in type 2 diabetes (T2DM) suggested a mild glycemic progression in statin treated. Since this effect has not yet elucidated in real world, we investigated the effects of different statins on glycemia in T2DM clinic outpatients.
  
  
  METHODS
  In a retrospective cohort study, we recorded at 6 and 12months modifications of fasting glucose (FPG), HbA1c, diabetes intensification therapy and target rate for HbA1c in 421 T2DM non-users and new statin users. Statins were categorized with low or high potency.
  
  
  RESULTS
  Compared to statin users, no statin group showed a significant HbA1c reduction from 52.8±14.0mmol/mol to 48.2±8.5 (p=0.003) at 6months and 48.6±8.8 (p=0.007) at 12months. This trend without statins was also observed in FPG starting from 7.1±2.0mmol/l to 6.7±1.6 (p=0.12) at 6months and 6.6±1.5 (p=0.032) at 12months. Statins determined a significant diabetes treatment intensification: 48.7% vs 27.4% (p=0.002) with hazard ratio 2.4 [95% CI 1.14-5.2], p=0.022. HbA1c target was significantly lower in statin users 62.0% vs 75.4%, p=0.042. Only lower-potency statins showed a significant reduction of HbA1c from 52.0±11.1mmol/mol to 50.7±9.0 (p=0.017) and 50.7±9.5 (p=0.038) at 6 and 12months, respectively. The same effect for these statins was registered in FPG from 7.5±2.2mmol/l to 7.0±1.6 (p=0.021) at 6months and 7.2±1.5 (p=0.026) at 12months.
  
  
  CONCLUSIONS
  In patients receiving statin therapy a greater intensification diabetes therapy is need. This impact seems to be less pronounced by statins with lower potency.
authors.affiliation: Department of Biomedical Clinical and Experimental Sciences, University of Florence, Italy.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Bardini
authors.affiliation: Diabetology Unit, Careggi Hospital, Florence, Italy. Electronic address: s.giannini@dfc.unifi.it.
authors.forename: Stefano
authors.initials: S
authors.lastname: Giannini
authors.affiliation: Department of Biomedical Clinical and Experimental Sciences, University of Florence, Italy; Diabetology Unit, Careggi Hospital, Florence, Italy.
authors.forename: Carlo Maria
authors.initials: CM
authors.lastname: Rotella
authors.affiliation: Diabetology Unit, Careggi Hospital, Florence, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Pala
authors.affiliation: Diabetology Unit, Careggi Hospital, Florence, Italy.
authors.forename: Barbara
authors.initials: B
authors.lastname: Cresci
authors.affiliation: Department of Biomedical Clinical and Experimental Sciences, University of Florence, Italy; Diabetology Unit, Careggi Hospital, Florence, Italy.
authors.forename: Edoardo
authors.initials: E
authors.lastname: Mannucci
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D006943:Hyperglycemia / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology; D007003:Hypoglycemia / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies
chemical_list: D001786:Blood Glucose; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
keywords: Diabetes; HbA1c; Hydroxy-methylglutaryl-CoA reductase inhibitors; Hypercholesterolemia; Statins