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It is known that statins effectively reduce the risks of heart attack and stroke in people with type 2 diabetes by cholesterol lowering, but it is not known whether statin use affects the development of small blood vessel complications, such as eye, nerve, and kidney disease in individuals with diabetes. This study tested the hypothesis that statin use increases the risk of diabetic retinopathy, diabetic neuropathy, diabetic nephropathy, and gangrene of the foot in individuals with diabetes. The researchers used data from the Danish Patient Registry and looked at patients age 40 or older who were diagnosed with diabetes between 1996 and 2009. The microvascular complication outcome of 15,679 patients who had used statins regularly before their diabetes diagnosis were compared with 47,037 patients who had not used statins prior to diagnosis. Results showed median follow-up of 2.7 years (range of 0-13). Patients who used statins were 34% less likely to be diagnosed with diabetic neuropathy (hazard ratio 0·60, 95% CI 0·57—0·75; p<0·0001), 40% less likely to develop diabetic retinopathy (hazard ratio 0·60, 95% CI 0·54—0·66; p<0·0001), and had a 12% reduced risk of gangrene of the foot (hazard ratio 0·88, 95% CI 0·80—0·97; p=0·0001) compared to those who had not received statins. The occurrence of diabetic nephropathy was similar between groups (hazardous ration 0.97, 95% CI 0.85-1.10; P=0.62). The study authors concluded that there was no association between statin use and an increased risk of microvascular disease. Despite the positive results, researchers suggest that additional research will be needed to determine if statins are protective against microvascular complication associated with diabetes.
Practice Pearls:
Nielsen SF, Nordestgaard BG ”Statin use before diabetes diagnosis and risk of microvascular disease: a nationwide nested matched study” Lancet Diabetes Endocrinol 2014; DOI: 10.1016/S2913-8587(14)70173-1. From http://www.diabetesincontrol.comNyhetsinfo www red DiabetologNytt |
