engleski

The Use of Statins Is Associated with Insulin Sensitivity Decrease in Type 1 Diabetes Mellitus: Prospective Observational Study

Statins are effective in the primary and secondary prevention of cardiovascular events in diabetes mellitus (DM). Emerging evidence suggest that statins might reduce insulin sensitivity and secretion. We investigated the effect of statin therapy introduction on insulin sensitivity in type 1 DM patients (N=832) aged 25-61 years during 5 year follow up. Insulin sensitivity was accessed using equation derived from euglycemic-hyperinsulinemic clamp studies-estimated glucose disposal rate (eGDR). Patients who started statin therapy (N= 345, 41.47% ; 59.42% atorvastatin and 40.58% simvastatin) showed a greater insulin sensitivity decrease (19.27 % vs 12.82 %, p<0.001) and metabolic control deterioration compared to statin free group (Table). The risk of insulin sensitivity decrease attributable to statin use was 36.7% (HR 1.36 (1.31-1.43) after adjustments for age, gender, disease duration, smoking status and the concomitant antihypertensive therapy. Patients on statins were further divided according to the median percentage of eGDR reduction (19.27%) which revealed that the risk of eGDR reduction was significantly atributable to baseline glycated haemoglobin (HR 1.96 ; 95%CI 1.61-2.39). The cardiovascular benefits of statin treatment might outweigh the risk of developing insulin resistance, but the possible metabolic control worsening merits to be considered.

type 1 diabetes mellitu; insulin sensitivity; statins

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