Lipid-lowering drugs and risk of new-onset diabetes: a cohort study using Japanese healthcare data linked to clinical data for health screening
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  • Published on:
    New onset diabetes and statins – real risk not so trivial
    • Anil Kumar Pareek, Medical Research Ipca Laboratories Ltd.
    • Other Contributors:
      • Nitin Bhalchandra Chandurkar, Clinical research
      • Kumar Bhaskar Naidu, Clinical Research
      • Shruti Kiran Dharmadhikari, Clinical Research

    We have read the article by Ooba N et al with interest. The authors have conducted a retrospective cohort study to assess the risk of new-onset diabetes associated with lipid-lowering drugs in Japanese population.

    Authors have excluded patients with diabetes characterized by HbA1c ≥6.5% or fasting blood glucose ≥126 mg/dL. However, in Table 1 (Baseline characteristics), patients are not categorized based on their HbA1c or blood sugar fasting levels as pre-diabetic (HbA1C between 5.7 to 6.4) or normoglycemic. It is important to note that the risk of new-onset diabetes among lipid-lowering users is particularly high in pre-diabetic patients (1) and hence, authors should have categorized the patients as either pre-diabetic or normoglycemic. Looking at the mean HbA1c not more than 5.2% in various groups (Table 1), it appears that the number of patients with pre-diabetes were not high. This finding of normoglycemics converting rapidly into diabetes in a mean duration of 4 to 5 months of statin use points to the gravity of the problem of statin associated diabetes which will have huge implication in clinical practice, wherein a short exposure to statins (4 to 5 months) can have the risk of shifting glucose homeostasis towards diabetes. Unlike other previous studies, wherein pitavastatin use was not associated with adverse effects on glycemic control (2, 3, 4), in this study, the risk of new-onset diabetes was highest with pitavastatin (HR-3.11). Authors should comment o...

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    Conflict of Interest:
    Authors are involved in research studies on statins and hydroxychloroquine.