QOF target warning as statins linked to 46% greater diabetes risk

Research linking statins to a significantly higher risk of diabetes strengthens evidence that prescribing rates for the drugs should not be incentivised through the QOF, GP leaders have warned.

Diabetes: statins linked to higher risk (Photo: iStock)
Diabetes: statins linked to higher risk (Photo: iStock)

Men who took statins had a 46% higher chance of developing type 2 diabetes, with the risk being dose-dependent for simvastatin and atorvastatin, according to a study in the journal Diabetologica.

High-dose simvastatin was associated with a 44% increased risk of developing diabetes, while for low-dose simvastatin the increased risk was 28%.

The link between statins and diabetes has been found in previous studies, but the researchers say this is the first paper to look at the general population. The team, from the University of Eastern Finland, looked at 8,749 men aged between 45 and 73.

Statins debate

The study adds new evidence to the debate around increased use of statins. NICE guidance published last year said GPs should prescribe statins to people who were at 10% risk of cardiovascular disease in the next 10 years – a recommendation that was challenged by the GPC.

Dr Andrew Green, chairman of the GPC’s clinical and prescribing subcommittee, told GP: ‘Last summer the GPC expressed to NICE its concerns that, for patients at low risk of cardiovascular disease, the benefits of statins were likely to be outweighed by the risks, and one of the concerns raised was about a possible link with the development of diabetes.

‘Although these concerns were dismissed at the time this is a further piece of evidence that appears to support our view, which of course is not an isolated one.

'Of particular interest is the apparent dose relationship discovered, as the latest NICE guidance on lipid management recommends more intensive treatment than previously was the case.’

Potential QOF indicators currently out for consultation include one to measure the number of patients treated according to the lower threshold.

’The GPC has already expressed opposition to the proposal to include rates of statin prescribing into QOF - there can be no justification for this measure,’ Dr Green said.

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