Aim. Current review summarized and analysed existing evidence of diabetogenic effect of statins and potential ways to overcome this problem in non-diabetic and diabetic patients. Materials and methods. Systematic literature review included results of experimental and clinical studies, multi-center placebo-controlled trials (JUPITER, ТNТ, IDEAL, SPARCL, METSIM, WOSCOPS, ALLHAT-LLT, PROSPER, etc.), systematic reviews and meta-analyses, current guidelines on statin prescription in high-risk patients and non-diabetic patients.Results of the reviewed clinical trials assessing the effects of long-term statin administration, data from randomized clinical trials and genetic studies provide convincing evidence of small, yet significant increase in absolute risk of new-onset diabetes (1 case of diabetes per 1000 patients per 1 year of treatment), concurrently preventing 5 new cases of cardiovascular disease. Diabetogenic properties are identified as probable class-effect of statins, with risk increased in high-intensity statin therapy. Diabetogenic effects are mediated through reduction in pancreatic β-cell function and impaired insulin resistance. Based on current international guidelines (ESC 2019, ADA 2020), the article highlights that despite modest diabetogenic potential, statins are recommended for primary and secondary prevention in patients with high risk of cardiovascular complications, including patients with diabetes. Conclusions. Statin therapy, especially high-intensity dosing can promote new cases of diabetes, particularly in patients with pre-existing metabolic syndrome and insulin resistance. Despite moderate diabetogenic effect statins are routinely recommended (ESC 2019, ADA 2020) for primary and secondary prevention in patients at high risk of cardiovascular complications, including diabetic patients. Statin therapy should be tailored to patient’s age, sex, concomitant diseases, parameters of lipid and glucose metabolism and presence of additional diabetogenic risk factors. Patients require lifestyle modification to reduce the risk of diabetes.
CV2: COST-EFFECTIVENESS OF TREATING HIGH-RISK INDIVIDUALS, AGED 45-65, WITH STATINS IN GERMANY FOR PRIMARY AND SECONDARY PREVENTION OF CORONARY HEART DISEASE
