Do statins interfere with lifestyle intervention in the prevention of diabetes in primary healthcare? One-year follow-up of the FIN-D2D project
- Nina Rautio1,
- Jari Jokelainen2,3,
- Heikki Oksa1,
- Timo Saaristo1,4,
- Markku Peltonen5,
- Mauno Vanhala6,
- Hannu Puolijoki7,
- Leena Moilanen8,
- Jaakko Tuomilehto5,9,
- Sirkka Keinänen-Kiukaanniemi2,3,
- Matti Uusitupa10,11
- 1Pirkanmaa Hospital District, Tampere, Finland
- 2Institute of Health Sciences, University of Oulu, Oulu, Finland
- 3Unit of General Practice, Oulu University Hospital, Oulu, Finland
- 4Finnish Diabetes Association, Tampere, Finland
- 5Diabetes Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland
- 6Unit of Family Practice, Central Finland Health Care District, Jyväskylä, Finland
- 7Department of Internal Medicine, Seinäjoki Central Hospital, Seinäjoki, Finland
- 8Department of Medicine, Kuopio University Hospital, Kuopio, Finland
- 9Center for Vascular Prevention, Danube-University Krems, Krems, Austria
- 10Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
- 11Research Unit, Kuopio University Hospital, Kuopio, Finland
- Correspondence to Dr Nina Rautio;
- Received 15 May 2012
- Accepted 15 August 2012
- Published 13 September 2012
Objectives To examine whether the use of statins is associated with the incidence of type 2 diabetes (T2D) and changes in glucose metabolism among individuals at high risk for T2D participating in 1-year lifestyle intervention in primary healthcare setting.
Design Prospective follow-up study.
Setting In all, 400 primary healthcare centres and occupational healthcare clinics in Finland.
Participants We screened altogether 10 149 individuals at increased risk for T2D; of these, 2798 non-diabetic individuals verified by a 2 h glucose tolerance test participated in the 1-year follow-up.
Interventions Lifestyle intervention (individual and/or group-based counselling).
Primary outcome measures Incidence of T2D and fasting and 2 h glucose measured at baseline and follow-up.
Results A total of 484 individuals (17.3%) used statins at the baseline. Of them 31 (7.5%) developed T2D during the follow-up, compared to 126 (6.5%) of statin non-users (OR 1.17, 95% CI 0.78 to 1.76, p=0.442). Interestingly, fasting glucose increased by 0.08 mmol/l in statin users, but remained unchanged in non-users, the difference being 0.074 mmol/l (95% CI 0.014 to 0.134) and remained significant even after adjustment for age, sex, baseline fasting glucose, the presence of cardiovascular disease (CVD), use of antihypertensive and/or coronary artery disease medication, weight and 1-year weight change (adjusted p=0.042).
Conclusions The incidence of T2D did not differ between the statin users and non-users. The finding that fasting glucose slightly increased in statin users in spite of lifestyle interventions suggests the view that the use of statins might have unfavourable effects on glucose metabolism and that statins might hamper beneficial effects of lifestyle intervention in people at high risk of T2D.
This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/2.0/ and http://creativecommons.org/licenses/by-nc/2.0/legalcode.