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The statin diabetes conundrum: short-term gain, long-term risk or inconvenient truth?
  1. Robert J DuBroff
  1. Division of Cardiology, Department of Internal Medicine, University of New Mexico School of Medicine, Albuquerque, New Mexico, USA
  1. Correspondence to: Dr Robert J DuBroff
    , Division of Cardiology, Department of Internal Medicine, MSC 10-5550, 1 University of New Mexico, Albuquerque, NM 87131 USA; rodubroff{at}salud.unm.edu

Extract

Statin drugs have become the mainstay of many cardiovascular disease prevention guidelines and are recommended for most adult patients with diabetes. A careful review of the evidence, however, suggests that the clinical benefits of statins in diabetes may have been overstated by relying on meta-analyses that incorporate randomised controlled trials (RCTs) neither designed nor powered to assess the effects of statins in diabetes. Multiple RCTs specifically designed and powered to study the effects of statins in diabetes have demonstrated inconsistent clinical benefits and no mortality benefit. The conclusions of these meta-analyses should not supersede the results of these large, well-conducted RCTs. Reports that conclude that the benefits of statins outweigh the risks have probably underestimated the long-term risks of statin exposure and the deleterious consequences of long-term diabetes.

  • PREVENTIVE MEDICINE

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Extract

Statin drugs have become the mainstay of many cardiovascular disease prevention guidelines and are recommended for most adult patients with diabetes. A careful review of the evidence, however, suggests that the clinical benefits of statins in diabetes may have been overstated by relying on meta-analyses that incorporate randomised controlled trials (RCTs) neither designed nor powered to assess the effects of statins in diabetes. Multiple RCTs specifically designed and powered to study the effects of statins in diabetes have demonstrated inconsistent clinical benefits and no mortality benefit. The conclusions of these meta-analyses should not supersede the results of these large, well-conducted RCTs. Reports that conclude that the benefits of statins outweigh the risks have probably underestimated the long-term risks of statin exposure and the deleterious consequences of long-term diabetes.

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