Highlights
- •Statin use has been associated with increased risk of developing type 2 diabetes (T2DM), and with impaired glycemic control in T2DM patients.
- •The association between statin use and glycemic control in type 1 diabetes (T1DM) is unknown.
- •In the present study of patients with T1DM, use of statins is independently associated with impaired glycemic control.
- •These results are the first in patients with T1DM, and may indicate a need to revisit dose of insulin when starting statin treatment.
Abstract
Aims
Statin use has been associated with increased risk of developing type 2 diabetes (T2DM),
and with impaired glycemic control in T2DM patients. The association between statin
use and glycemic control in type 1 diabetes (T1DM) is unknown. The association between
use of statins and glycemic control in T1DM patients without known heart disease was
examined.
Methods
Cross-sectional study of 1093 T1DM patients from the outpatient clinic at Steno Diabetes
Center. Physical examination, questionnaires, and echocardiography were performed
in all patients. Investigators were blinded to all laboratory measurements. Data were
analyzed in uni-and multivariable models.
Results
Mean age 49.6 years, 53% men, mean diabetes duration 25.5 years, 475 (43.5%) received
statins. In baseline analyses statin users tended to be older, have longer diabetes
duration, and have more severe kidney disease. Left ventricular ejection fraction
was not associated with statin use. In multivariable models including age, gender,
diabetes duration, BMI, blood pressure, physical activity, family history of cardiovascular
disease, physical activity, albuminuria, eGFR, retinopathy, smoking, cholesterol,
ejection fraction, triglycerides, and use of ACE/ATII-antagonists, aspirin, calcium-antagonists,
betablockers or diuretics, statin use was independently and significantly associated
with higher HbA1c (0.2% (95%CI: 0.1; 0.4) (2.0 mmol/mol (0.2; 3.8)), p = 0.029).
Conclusions
In T1DM, use of statins is independently associated with impaired glycemic control.
A causal relationship cannot be determined from this study. Given the benefit on cardiovascular
outcome, this should not cause patients to stop statin treatment, but may indicate
a need to revisit dose of insulin when starting statin treatment.
Abbreviations:
T1DM (type 1 diabetes), LVEF (left ventricular ejection fraction), ICD (implantable cardioverter defibrillator)Keywords
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Article info
Publication history
Published online: October 21, 2015
Accepted:
October 11,
2015
Received in revised form:
October 5,
2015
Received:
September 3,
2015
Identification
Copyright
© 2015 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
