医学
糖尿病
2型糖尿病
他汀类
内科学
安慰剂
随机对照试验
物理疗法
内分泌学
替代医学
病理
标识
DOI:10.1016/j.beem.2023.101749
摘要
Randomized trials suggest moderate-intensity statins increase type 2 diabetes risk by around 11% with a potential further 12% moving to high-intensity statins, such that high intensity may increase risk by 20% or more relative to placebo. These data translate into one extra diabetes case per 100-200 statin recipients over 5 years, with ∼10-fold greater benefits on major vascular outcomes. The underlying mechanisms for diabetes harm are not clear but could include modest weight gain (noted in randomized trials), or, speculatively, beta cell harm. Concordant genetic studies link HMG CoA Reductase inhibition to diabetes risk and weight gain. Patients should be warned about a slight diabetes risk when prescribed statin and told that modest lifestyle improvements can i) nullify diabetes risk, and ii) improve cardiovascular risks beyond statins. Doctors should also measure glycemia status post statin commencement, most commonly with HbA1c, and tailor lifestyle advice and care dependent on the results.
科研通智能强力驱动
Strongly Powered by AbleSci AI