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Glycaemic Effects of Non-statin Lipid-Lowering Therapies

Patrick D Collins1, Naveed Sattar2

  • 1University Hospital Lewisham, Lewisham High Street, London, SE13 6LH, UK.

Current Cardiology Reports
|November 20, 2016
PubMed

Insights

Statins may slightly increase diabetes risk, but benefits outweigh risks. Other lipid-lowering drugs like PCSK9 inhibitors show minimal glycemic effects, unlike older niacin therapies.

Area of Science:

  • Cardiology
  • Endocrinology
  • Pharmacology

Background:

  • The JUPITER trial highlighted potential adverse glycemic effects of statin therapy.
  • Emerging evidence suggests links between lipid metabolism and glycemic control, prompting investigation into broader diabetogenic effects of lipid-lowering drugs.

Purpose of the Study:

  • To review the glycemic effects of various lipid-lowering therapies.
  • To assess the impact of statins, PCSK9 inhibitors, niacin, ezetimibe, and fibrates on glycemic control.

Main Methods:

  • Review of existing clinical trial data and genetic studies.
  • Analysis of evidence regarding the diabetogenic potential of different lipid-lowering drug classes.

Main Results:

  • Statins show a modest increase in new diabetes mellitus risk, generally outweighed by cardiovascular benefits.
  • PCSK9 inhibitors currently show no major glycemic effect, pending large-scale trial results, though genetic data suggests a potential link.
  • Niacin demonstrates a clear diabetogenic effect, while evidence for ezetimibe and fibrates is limited but not concerning.

Conclusions:

  • Current evidence suggests glycemic effects should minimally influence clinical decisions regarding lipid-lowering therapies.
  • Further research is necessary to fully understand the complex relationship between lipid metabolism and glycemic control.
Keywords:
DiabetesEzetimibeHypercholesterolaemiaNiacinPCSK9Statins

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