Statin Induced New-onset Diabetes Mellitus - A Narrative Review

Statins are widely used to lower LDL cholesterol and prevent cardiovascular disease. Although generally safe, there is increasing evidence that they may increase the risk of new-onset diabetes mellitus (NODM). Recent studies show a modest but consistent rise in diabetes risk associated with statin use, especially among individuals with prediabetes, obesity, or other metabolic risk factors. High-intensity statins like atorvastatin and rosuvastatin carry a greater risk compared to agents such as pravastatin or pitavastatin. Proposed mechanisms include increased insulin resistance, impaired insulin secretion, and changes in hepatic glucose production. Despite the diabetes risk associated with statins, their well-established cardiovascular benefits generally outweigh this concern. This review discusses the current evidence on the association between statin use and NODM, explores potential biological mechanisms, compares the diabetogenic effects of different statins, assess the impact of statin dose and intensity, and outlines implications for clinical practice.