Statin use has been reported to increase the risk of new onset diabetes, and potentially worsen glycemic control in patients with type 2 diabetes (T2D). The risk of new onset diabetes from statin is higher with increased dose of statin administration. This study was aimed to evaluate the effects of high-intensity statins as compared to the lower intensity statins on glucose homeostasis and glycemic control in patients with T2D. T2D who were taking simvastatin up to 20 mg/day (N=100) were randomized to continue using the same dosage of simvastatin (low- to moderate-intensity statin group; LS) for 12 weeks or change to atorvastatin 40 mg/day for 6 weeks and if tolerable increased to atorvastatin 80 mg/day for 6 weeks (high-intensity statin group; HS). Fasting plasma glucose (FPG), HbA1c, fasting plasma insulin, HOMA-IR and HOMA-B were assessed at baseline, 6 weeks and 12 weeks. Oral hypoglycemic agents were unchanged throughout the study period and patients who were on human insulin were excluded from the analysis. Ninety-eight patients completed the study (73% female), mean age 58.9±9.6 years, mean BMI 27.3±4.5 kg/m2, median duration of diabetes was 102 (48-180) months. Mean baseline FPG and HbA1c were 130.4±35.3 mg/dl and 6.9±0.9%, respectively. Median baseline insulin level, HOMA-IR, and HOMA-B were 10.8 (7.5-17.7) mIU/L, 3.3 (2.2-5.5), and 65.5 (37.7-113.8), respectively. There was no significant difference in baseline characteristic and baseline glucose homeostasis parameters between the LS (n=49) and HS group (n=51). There was a slight increase in HbA1c in the HS group as compared to the LS group at 6 weeks (+0.1% vs. 0%, p=0.05), and 12 weeks (+0.1% vs. -0.1%, p=0.13) respectively. However; there were no significant changes in FPG, fasting plasma insulin, HOMA-IR and HOMA-B between the LS and HS group.
In conclusion, there was no significant deterioration in glucose homeostasis with high-intensity statins as compared to low dose statins in patients with T2D.
N. Thongtang: Other Relationship; Self; Pfizer Inc.. S. Sriussadaporn: None. N. Tangkittikasem: None.