Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • News & Views
  • Published:

DIABETES

Statins and diabetes mellitus progression: a fly in the ointment?

Statins might exert diabetogenic effects, potentially increasing insulin resistance and worsening glucose control. However, patients with diabetes mellitus are at high or very high cardiovascular risk and, thus, statin use is strongly recommended. Adding ezetimibe to statins might be helpful in achieving lipid targets and reducing cardiovascular risk without adversely affecting glucose metabolism.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

References

  1. Mansi, I. A. et al. Association of statin therapy initiation with diabetes progression: a retrospective matched-cohort study. JAMA Intern. Med. https://doi.org/10.1001/jamainternmed.2021.5714 (2021).

    Article  PubMed  Google Scholar 

  2. Mach, F. et al. 2019 ESC/EAS guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk. Eur. Heart J. 41, 111–188 (2020).

    Article  Google Scholar 

  3. Wu, H., Shang, H. & Wu, J. Effect of ezetimibe on glycemic control: a systematic review and meta-analysis of randomized controlled trials. Endocrine 60, 229–239 (2018).

    Article  Google Scholar 

  4. Cho, Y. et al. Effect of ezetimibe on glucose metabolism and inflammatory markers in adipose tissue. Biomedicines 8, 512 (2020).

    Article  CAS  Google Scholar 

  5. Giugliano, R. P. et al. Benefit of adding ezetimibe to statin therapy on cardiovascular outcomes and safety in patients with versus without diabetes mellitus: results from IMPROVE-IT (Improved Reduction of Outcomes: Vytorin Efficacy International Trial). Circulation 137, 1571–1582 (2018).

    Article  CAS  Google Scholar 

  6. de Carvalho, L. S. F., Campos, A. M. & Sposito, A. C. Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors and incident type 2 diabetes: a systematic review and meta-analysis with over 96,000 patient-years. Diabetes Care 41, 364–367 (2018).

    Article  Google Scholar 

  7. Sánchez-García, A., Simental-Mendía, M. & Simental-Mendía, L. E. Effect of proton-pump inhibitors on glucose and insulin metabolism on patients with type 2 diabetes: a systematic review and meta-analysis of randomized controlled trials. Curr. Pharm. Des. 26, 4007–4013 (2020).

    Article  Google Scholar 

  8. Peng, C. C. et al. Effects of proton pump inhibitors on glycemic control and incident diabetes: a systematic review and meta-analysis. J. Clin. Endocrinol. Metab. 106, 3354–3366 (2021).

    Article  Google Scholar 

  9. Wang, K. Y. et al. Histamine regulation in glucose and lipid metabolism via histamine receptors: model for nonalcoholic steatohepatitis in mice. Am. J. Pathol. 177, 713–723 (2010).

    Article  CAS  Google Scholar 

  10. Katsiki, N., Banach, M. & Mikhailidis, D. P. Is type 2 diabetes mellitus a coronary heart disease equivalent or not? Do not just enjoy the debate and forget the patient! Arch. Med. Sci. 15, 1357–1364 (2019).

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Niki Katsiki.

Ethics declarations

Competing interests

N.K. has given talks, attended conferences and participated in trials sponsored by Astra Zeneca, Bausch Health, Boehringer Ingelheim, Elpen, Novartis, Novo Nordisk, Sanofi, Servier, Viatris and Vianex. D.P.M. has given talks, acted as a consultant or attended conferences sponsored by Amgen and Novo Nordisk.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Katsiki, N., Mikhailidis, D.P. Statins and diabetes mellitus progression: a fly in the ointment?. Nat Rev Endocrinol 18, 137–138 (2022). https://doi.org/10.1038/s41574-021-00612-z

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41574-021-00612-z

Search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing