title: Effect of Atorvastatin on Glycaemic Parameters in Normoglycaemic and Prediabetic Subjects: A Prospective, Panel Study.
abstract: BACKGROUND
  Type 2 diabetes is associated with obesity and dyslipidemia, which are risk factor for cardiovascular disease. With recent FDA approved indications for statins being widened because of its lipid lowering and pleiotropic effects, statins are currently amongst the most widely used drugs in patients with or without diabetes. Although cardiovascular risk is reduced by statin therapy, its association with the development of diabetes is disputed.
  
  
  OBJECTIVE
  This study was conducted to evaluate the effect of Atorvastatin on glycaemic status of normoglycaemic and prediabetic individuals.
  
  
  METHODS
  An observational, prospective panel study was conducted on 75 subjects who were on Atorvastatin therapy. After baseline data collection and investigations, subjects were recruited depending on their glycaemic status into three groups: normoglycaemic, Impaired Fasting Glucose (IFG) and Impaired Glucose Tolerance (IGT) group. Atorvastatin therapy was continued and the subjects were followed every 6 months up to 18 months. At every follow up all glycaemic parameters were evaluated and subjects were assessed for continuation of statin therapy, dosing schedule and possible adverse drug reactions.
  
  
  RESULTS
  All three groups as a whole, irrespective of dose of Atrovastatin therapy, showed a statistically significant (p<0.0001) increase in all glycaemic parameters. In normoglycaemic group with low dose Atorvastatin, there was no significant change in 2-hour Post Prandial Blood Sugar (PPBS) but change in HbA1c% (p=0.0004) and FBS (p<0.0001) was significant, whereas, with high dose, changes in 2-hr PPBS and HbA1c % were significant from 6 months onwards. In IFG group, both with low and high dose of Atorvastatin, there was significant change in all glycaemic parameters from 12 months onwards. In case of IGT, especially with high dose Atorvastatin, significant changes were evident from 6 months onwards.
  
  
  CONCLUSIONS
  Atorvastatin therapy especially with higher dose was found to be associated with glucose intolerance in normoglycaemics and also caused progression towards diabetes in prediabetic individuals.
authors.affiliation: Senior Resident, Department of Pharmacology, All India Institute of Medical Sciences (AIIMS) , Bhubaneswar, Odisha, India .
authors.forename: Sansita
authors.initials: S
authors.lastname: Parida
authors.affiliation: Associate Professor, Department of Pharmacology, Sri Ram Chandra Bhanja Medical College and Hospital , Cuttack, Odisha, India .
authors.forename: Trupti Rekha
authors.initials: TR
authors.lastname: Swain
authors.affiliation: Professor, Department of Cardiology, Sri Ram Chandra Bhanja Medical College and Hospital , Cuttack, Odisha, India .
authors.forename: Satya Narayan
authors.initials: SN
authors.lastname: Routray
authors.affiliation: Associate Professor, Department of Pharmacology, All India Institute of Medical Sciences (AIIMS) , Bhubaneswar, Orissa, India .
authors.forename: Rituparna
authors.initials: R
authors.lastname: Maiti
keywords: Dyslipidemia; HbA1c; Impaired fasting glucose; Impaired glucose tolerance; Prediabetic state