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Statin use in prediabetic patients: rationale and results to date

Prediabetes increases the risk for new-onset diabetes mellitus in patients receiving statins and this risk is dose- and time- dependent. Explanations for the conversion of a predisposed individual to diabetes are ambiguous including reductions in ubiquinone and adiponectin levels. However, the risk of new-onset diabetes mellitus is far outweighed by the statin-induced considerable decrease in cardiovascular events. Thus, prediabetic patients at high cardiovascular risk should not be denied high-dose statin therapy due to the small increase in the risk of developing diabetes since statins, especially at higher doses, cause greater reductions in cardiovascular events compared with standard statin doses. Moreover, lifestyle modification or even antidiabetic drugs are highly recommended in these individuals.