Browsing by Subject "heikentynyt glukoosinsieto"

Cholesterol-lowering statins are well-tolerated and effective in prevention of cardiovascular diseases. One of the target groups in treatment of dyslipidaemia is type 2 diabetics, who benefit from reducing cholesterol levels even without a history of cardiovascular disease or high cholesterol levels. Common adverse events associated with statins are myopathy and an increase in liver enzymes. Statins have also been shown to slightly increase the risk of developing type 2 diabetes and increase blood glucose levels. The risk seems to increase with higher doses. Higher doses, however, prevent cardiovascular events more than moderate doses. In this cohort study we assessed the relationship between statins and development of diabetes in a Finnish diabetes prevention study. In addition, we assessed the effects of statins on blood glucose levels. The diabetes risk associated with statins was evaluated by a parametric survival-analysis and the impact on blood glucose levels by a mixture model. The material consisted of the follow-up data from the Diabetes Prevention Study (DPS) from year 1993 to 2009 and along with that statistics on reimbursements for prescription medicines from Kela's reimbursement database. The purpose of DPS was initially to determine if type 2 diabetes can be prevented or delayed by lifestyle intervention. Participants with impaired glucose tolerance were randomly assigned to the intervention group or the control group. The intervention group received intensive and individual counseling on healthy lifestyle while the control group was given general information on health behavior. The study revealed that 36,8 % (n = 182) of the participants had used statins during follow-up. Statin use was more common in the intervention than the control group. Simvastatin was the most used statin and statins had been used for four years on average. Statins were associated with a slight increase in risk of developing diabetes and an increase in fasting plasma glucose and 2 h glucose levels. The risk of diabetes was slighter in the intervention group. Further research is needed to determine the mechanism causing the increase in risk of diabetes, if different statins differ in the extent of risk and if a specific patient group or characteristic is more vulnerable to develop diabetes when exposed to statins. The diabetes risk associated with statins should be taken into account when designing a statin trial. Develoment of diabetes should be a pre-specified endpoint and blood glucose and insulin levels monitored during follow-up.