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Possible Diabetogenic Effects of Statins Therapy and its Clinical Implications

Agumas Alemu Alehegn, ZemeneDemelashKifle, Mohammedbrhan Abdelwuh

Statins, hydroxyl-methyl-glutaryl-coenzyme-A reductive inhibitors, are efficacious and safe drugs used for the management of hyperlipidemia and preventing primary and secondary cardiovascular disorders. This reduction is directly proportional to the reduction of LDL-cholesterol. However, different population-based and Meta-analyses studies showed an incidence of new-onset diabetes mellitus (NODM). Older age, females, obesity, Asian descent, the potency and intensity of statin therapy, existing metabolic disorders, altered blood glucose levels, and increased weight are highly prone to diabetes. Although, the definitive cause of new-onset diabetes mellitus is not ruled out, plenty of mechanisms have been suggested including inhibiting HMG-CoA reductase, decreasing expression of GLUTs, modifying lipoprotein particle size, decreasing adiponectin and ubiquinone levels. These mechanisms result in either increasing insulin resistance or decreasing insulin secretion. In addition, under dysmetabolic situations, statins may have pro-inflammatory effects through the induction of certain inflammasomes. According to existing evidence, prescribing this class of drugs should not be restricted in patients with high cardiovascular risk due to their risk is lower than their benefits. However, close monitoring of commonly available lab tests is recommended.

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