Brisbane, Australia—The risks of developing diabetes with statin use might be so great for older women that prescribers should consider discontinuing the cholesterol-lowering drugs.

That’s according to a new Australian study that found women aged >75 had a significantly increased risk for diabetes, 33%, if they took statins.

The University of Queensland–led research study pointed out that the risk increased to more than 50% in women taking higher doses of the drugs.

“We found that almost 50% of women in their late seventies and eighties in the study took statins, and 5% were diagnosed with new-onset diabetes,” explained Mark Jones, PhD. “Statins are highly prescribed in this age group but there are very few clinical trials looking at their effects on older women.”

He added, “The vast majority of research is on 40- to 70-year-old men.”

To determine the risks, the study team performed an analysis of a population-based longitudinal cohort study with data linkage to the Australian national death index, and to national databases of nonhospital episodes of medical care and prescription medications dispensed between July 1, 2002, and August 31, 2013. Participants were 8,372 Australian women born between 1921 and 1926, who were alive on January 1, 2003, and did not have a diabetes diagnosis. 

The report notes that, during 10 years of follow up, 49% of the cohort had filled a prescription for statins and 5% had initiated treatment for new-onset diabetes. Statin exposure was found to be associated with a higher risk of treatment for new-onset diabetes (hazard ratio 1.33), which equates to a number needed to harm (NNH) of 131 for 5 years of exposure to statins. Risk increased with increasing dose of statin from the hazard ratio of 1.17 for the lowest dose to 1.51 for the highest dose, study authors report.

“What's most concerning was that we found a ‘dose effect’ where the risk of diabetes increased as the dosage of statins increased,” Jones said; this is especially significant because “over the 10 years of the study most of the women progressed to higher doses of statins.”

“The dose–response for statins on new onset of diabetes suggests elderly women should not be exposed to higher doses of statins,” study authors conclude. “Elderly women currently taking statins should be carefully and regularly monitored for increased blood glucose to ensure early detection and appropriate management of this potential adverse effect, including consideration of de-prescribing.”

Jones urged that elderly women taking statins “should be carefully and regularly monitored for increased blood glucose to ensure early detection and management of diabetes.”
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