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Deterioration of glucose homeostasis in type 2 diabetic patients one year after beginning of statins therapy
Atherosclerosis, 07/03/2012
Clinical Article
Bellia A et al. – In well–controlled type 2 diabetic patients both rosuvastatin and simvastatin significantly impaired glycemic control and insulin secretion, without affecting insulin sensitivity.
Methods- After a 3 weeks run–in, 27 eligible patients were randomly assigned to receive either rosuvastatin 20 mg daily (Group 1) or simvastatin 20 mg daily (Group 2) for 6 months; thereafter they were switched to the other treatment for additional 6 months.
- Patients were recruited among individuals attending the outpatient service of the Diabetology Unit of the “Policlinico Tor Vergata” University Hospital, Rome, Italy.
- Serum lipids, glucose and insulin, glycated hemoglobin, C–reactive protein, TNF– α, leptin, adiponectin, insulin sensitivity by euglycemic–hyperinsulinemic clamp, β–cells function by HOMA– β were assessed at months 0, 6 and 12.
- Additionally, endothelial function was assessed by use of the brachial artery reactivity technique.
- Besides marked reduction in lipid levels, glycated hemoglobin significantly increased from baseline after 12 months in both Group 1 (+0.8 ± 0.2%, p < 0.001) and Group 2 (+0.9 ± 0.3%; p < 0.001).
- Similar trends were observed for fasting glucose in both groups.
- No changes in insulin sensitivity were detected throughout the study, whereas HOMA– β significantly decreased from baseline after 12 months in both Group 1 (–21.9%, p < 0.01) and Group 2 (–38.9%; p < 0.001).
- In addition, both treatments similarly decreased C–reactive protein and leptin, as well as improved endothelial function.
- No changes in anthropometric measures were observed.