title: Consensus on the Statin of Choice in Patients with Impaired Glucose Metabolism: Results of the DIANA Study.
abstract: OBJECTIVE
  Despite the recognized clinical benefit of statins on cardiovascular prevention, providing correct management of hypercholesterolaemia, possible adverse effects of their use cannot be disregarded. Previously published data shows that there is a risk of developing diabetes mellitus or experiencing changes in glucose metabolism in statin-treated patients. The possible determining factors are the drug characteristics (potency, dose), patient characteristics (kidney function, age, cardiovascular risk and polypharmacy because of multiple disorders) and the pre-diabetic state.
  
  
  METHODS
  In order to ascertain the opinion of the experts (primary care physicians and other specialists with experience in the management of this type of patient) we conducted a Delphi study to evaluate the consensus rate on diverse aspects related to the diabetogenicity of different statins, and the factors that influence their choice.
  
  
  RESULTS
  Consensus was highly significant concerning aspects such as the varying diabetogenicity profiles of different statins, as some of them do not significantly worsen glucose metabolism. There was an almost unanimous consensus that pitavastatin is the safest statin in this regard.
  
  
  CONCLUSIONS
  Factors to consider in the choice of a statin regarding its diabetogenicity are the dose and patient-related factors: age, cardiovascular risk, diabetes risk and baseline metabolic parameters (which must be monitored during the treatment), as well as kidney function.
authors.affiliation: Internal Medicine Department, Hospital General Universitario Gregorio Marañón, School of Medicine of the Universidad Complutense, Madrid, Spain. jesus.millan@salud.madrid.org.|Cátedra-Servicio de Medicina Interna, Hospital General Universitario Gregorio Marañón, Facultad de Medicina de la Universidad Complutense, Calle del Dr. Esquerdo, 46, 28007, Madrid, Spain. jesus.millan@salud.madrid.org.
authors.forename: Jesús
authors.initials: J
authors.lastname: Millán Núñez-Cortés
authors.affiliation: Nephrology Department, Hospital Clínic de Barcelona, Barcelona, Spain.
authors.forename: Aleix
authors.initials: A
authors.lastname: Cases Amenós
authors.affiliation: Endocrinology and Nutrition Department, Hospital Clínico Universitario, Universitat de Valencia, Valencia, Spain.
authors.forename: Juan Francisco
authors.initials: JF
authors.lastname: Ascaso Gimilio
authors.affiliation: Cardiology Department, Hospital Universitario Ramón y Cajal, Universidad de Alcalá, Madrid, Spain.
authors.forename: Vivencio
authors.initials: V
authors.lastname: Barrios Alonso
authors.affiliation: Centro de Salud Palleter, Castellón, Spain.
authors.forename: Vicente
authors.initials: V
authors.lastname: Pascual Fuster
authors.affiliation: Unit of Lipids and Vascular Risk, Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: Juan Carles
authors.initials: JC
authors.lastname: Pedro-Botet Montoya
authors.affiliation: Unit of Lipids and Vascular Risk, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain.
authors.forename: Xavier
authors.initials: X
authors.lastname: Pintó Sala
authors.affiliation: Centro de Salud de Repélega, Repélega, Portugalete, Vizcaya, Spain.
authors.forename: Adalberto
authors.initials: A
authors.lastname: Serrano Cumplido
mesh_terms: D032921:Consensus; D003697:Delphi Technique; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000139:chemically induced*; D005947:Glucose / Q000378:metabolism*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use*; D006937:Hypercholesterolemia / Q000188:drug therapy; D058007:Physicians, Primary Care; D011236:Prediabetic State / Q000139:chemically induced*; D011795:Surveys and Questionnaires
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D005947:Glucose
keywords: Diabetes; Impaired glucose tolerance Consensus; Statins