Evaluation of glycemic status among hypercholesterolemic patients on atorvastatin in a tertiary care hospital - A
R Nalini1, J Ezhil Ramya1, R Karthick1
1Department of Pharmacology, Government Tirunelveli Medical College, Tirunelveli¸ Tamil Nadu, India.
Insights
Atorvastatin use in hypercholesterolemic patients may increase the risk of developing new-onset diabetes mellitus. Monitoring glycemic status is crucial, especially with higher atorvastatin doses and in patients with diabetes risk factors.
Area of Science:
- Cardiology
- Endocrinology
- Pharmacology
Background:
- Statins, including atorvastatin, are widely used for cardiovascular disease prevention by lowering low-density lipoprotein cholesterol.
- Emerging evidence suggests a link between statin use and an increased incidence of new-onset diabetes mellitus.
- Atorvastatin, in particular, has been associated with a potential for worsening glucose control.
Purpose of the Study:
- To investigate the diabetogenic potential of atorvastatin in hypercholesterolemic patients.
- To assess the incidence of prediabetes and new-onset diabetes mellitus following atorvastatin therapy.
Main Methods:
- Retrospective cohort study conducted in a cardiology department.
- Inclusion criteria: hypercholesterolemic patients on atorvastatin for over 6 months with normal baseline glucose levels.
- Outcome assessment: development of prediabetes or new-onset diabetes mellitus, with adverse drug effects recorded and causality assessed.
Main Results:
- Out of 60 participants, 18 (30%) developed prediabetes (HbA1c 5.97 ± 0.22).
- 17 participants (28%) developed new-onset diabetes mellitus (HbA1c 7.24 ± 0.50).
- The 40 mg dose of atorvastatin was most frequently prescribed.
Conclusions:
- Atorvastatin exhibits a dose-dependent risk for new-onset diabetes mellitus.
- Periodic monitoring of glycemic status is recommended during statin therapy, particularly with high-dose atorvastatin and in patients with diabetes risk factors.
Introduction:
Statins are effective in reducing low-density lipoprotein cholesterol and are favorable in primary and secondary prevention of cardiovascular disease. Recent large trials have linked the use of statins and increased incidence of new-onset diabetes mellitus, the possibility of worsening of glucose level in individuals with diabetes following statin therapy, and this possibility is increased with the use of atorvastatin. This study was undertaken to analyze the possibility of the diabetogenic potential of atorvastatin among hypercholesterolemic patients.
Materials And Methods:
This retrospective cohort study was conducted in the cardiology department from July 2019 to December 2019. Patients on atorvastatin for more than 6 months with normoglycemia on commencement of therapy were included. The occurrence of prediabetes or new-onset diabetes mellitus after atorvastatin therapy is the outcome of the study. Adverse drug effects to atorvastatin were also recorded and WHO-UMC causality assessment was performed. Descriptive statistics were performed for baseline and demographic characteristics.
Results:
Sixty study participants were included in the study. Eighteen (30%) study participants developed prediabetes with an HbA1c value of 5.97 ± 0.22 and 17 (28%) of participants developed new-onset diabetes mellitus with an HbA1c value of 7.24 ± 0.50. Atorvastatin at dose of 40 mg was found to be the most frequently prescribed dose.
Conclusion:
Atorvastatin has a dose-dependent risk of developing new-onset diabetes mellitus. Hence, the following statin therapy glycemic status should be periodically monitored especially in patients with a large dose of atorvastatin and also in patients with higher risk factors for diabetes.
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