NEW YORK (Reuters Health) Dec 27 - In people with impaired glucose tolerance and other cardiovascular risk factors, use of diuretics or statins is tied to an increased risk of new-onset diabetes, according to re-analysis of data from a large trial.
The clinical implications, Dr. Henry Krum told Reuters Health by email, "are that patients receiving diuretics and statins should be regularly and closely monitored regarding their glycemic control as they are at increased risk for diabetes."
In a paper online December 9 in the British Medical Journal, Dr. Krum of Monash University in Melbourne, Australia, and colleagues note that despite the overwhelming benefits of these drugs and beta-blockers on cardiovascular outcomes, recent evidence suggests that long-term use may increase the risk of diabetes.
To investigate further, the researchers examined data from a trial involving more than 24,000 patients with impaired glucose tolerance. Many had never taken the agents in question before.
Of these patients, during a median of five years of follow-up, beta-blockers were started in 915 (16.2%), diuretics in 1,316 (20.7%) and statins in 1,353 (22.0%).Use of a calcium channel blocker was employed as a metabolically neutral control; these were started in 1,171 participants (18.6%).
After adjustment, in this treatment-naïve population, diuretics were associated with a significantly increased risk of new onset diabetes (hazard ratio, 1.23). This was also true of statins (HR,1.32), but not of beta-blockers.
Among shortcomings of the study say the investigators, is the lack of information about dosages and the fact that outcome was not stratified by duration of use.
"Our findings suggest that glycaemia should be better monitored when these drugs are initiated in high risk patients," the researchers write.
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