Risk of New-Onset Diabetes Mellitus Among Adults Using Statins: A Retrospective Cohort Study in Thailand

This study aimed to evaluate the incidence of new-onset diabetes mellitus (NODM) in statin users versus non-users and identify associated risk factors. Retrospective cohort studies leverage real-world data to address gaps in controlled trials, particularly in regions like Thailand, where local factors may affect this association.

This study was a retrospective cohort study conducted at Phramongkutklao Hospital in Bangkok, Thailand. Using historical medical records, we identified two distinct cohorts - statin users and non-users - and followed them over time (2013-2022) to evaluate the incidence of NODM. A total of 113,850 patients aged over 20 years were included, with 14,120 (12.4%) statin users and 99,730 (87.6%) non-users. The annual incidence of NODM was calculated for each year of the study period, with statistical analyses (chi-square tests and Poisson regression) performed to identify risk factors.

Statin users had a significantly higher incidence of NODM, with 2,957 cases (20.94%) occurring during the follow-up period, compared to 1,643 cases (1.65%) among non-users. Older age, hypertension, and hypercholesterolemia were significantly associated with an increased risk of NODM in statin users. Multivariable analysis showed that statin use increased the risk of NODM by 3.86 times (95% CI: 3.58-4.17, p < 0.001) compared to non-users. The use of non-statin lipid-lowering drugs, as well as obesity, also contributed to the elevated diabetes risk among statin users.

Statin use is associated with a significantly higher risk of NODM, particularly in older adults and those with pre-existing cardiovascular risk factors. These findings emphasize the need for careful glucose monitoring in statin users and suggest a potential role for lifestyle interventions in mitigating this risk. Further studies are needed to explore strategies for balancing the cardiovascular benefits of statins with their potential metabolic risks.