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Debate: Lipid-lowering Therapies and Diabetes Development

Julia Brandts1,2, Dirk Müller-Wieland3

  • 1Department of Internal Medicine I, University Hospital Aachen, Pauwelsstraße, 30 52074, Aachen, Germany.

Current Atherosclerosis Reports
|January 8, 2025
PubMed
Abstract

Insights

Statins increase the risk of new-onset diabetes (NOD) in a dose-dependent manner, potentially by affecting pancreatic beta cells. Alternative therapies may offer safer options for at-risk patients.

Area of Science:

  • Cardiovascular Medicine
  • Endocrinology
  • Pharmacology

Background:

  • Lipid-lowering therapies, particularly statins, are widely used for cardiovascular disease prevention.
  • Emerging evidence suggests a link between statin use and an increased risk of new-onset diabetes (NOD).

Purpose of the Study:

  • To review the relationship between statins and NOD risk.
  • To explore the underlying mechanisms of this association.
  • To compare the NOD risk of statins with other lipid-lowering agents.

Main Methods:

  • Systematic review of meta-analyses and relevant genetic/experimental studies.
  • Analysis of mechanisms affecting insulin secretion and beta-cell function.

Main Results:

  • Meta-analyses confirm a dose-dependent increase in NOD risk with statins, especially high-intensity ones.
  • Statins may impair insulin secretion via effects on G protein function, calcium signaling, and beta-cell cholesterol homeostasis.
  • Unlike other LDL-lowering drugs, statins appear to have specific mechanisms contributing to NOD risk.

Conclusions:

  • Statins offer cardiovascular benefits but carry an increased NOD risk, potentially due to intracellular pathways affecting liver and beta-cell function.
  • Personalized treatment strategies and alternative lipid-lowering therapies may be safer for diabetic patients.
  • Findings may influence future clinical guidelines and therapeutic approaches for lipid management.
Keywords:
Cardiovascular riskDiabetes mellitusLDL-cholesterolLipid-lowering therapiesStatins

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