Recent reports indicate that statins are associated with an increased risk for new-onset
diabetes mellitus (DM) compared with placebo and that this relation is dose dependent. The
aim of this study was to perform a comprehensive network meta-analysis of randomized
controlled trials (RCTs) investigating the impact of different types and doses of statins on
new-onset DM. RCTs comparing different types and doses of statins with placebo were
searched for using the MEDLINE, Embase, and Cochrane databases. A search of RCTs
pertinent to this meta-analysis covering the period from November 1994 to October 2012
was conducted by 2 independent investigators using the MEDLINE, Cochrane, Google
Scholar, and Embase databases as well as abstracts and presentations from major cardiovascular
meetings. Seventeen RCTs reporting the incidence of new-onset DM during statin
treatment and including a total of 113,394 patients were identified. The RCTs compared
either a statin versus placebo or high-dose versus moderate-dose statin therapy. Among
different statins, pravastatin 40 mg/day was associated with the lowest risk for new-onset
DM compared with placebo (odds ratio 1.07, 95% credible interval 0.86 to 1.30).
Conversely, rosuvastatin 20 mg/day was numerically associated with 25% increased risk for
DM compared with placebo (odds ratio 1.25, 95% credible interval 0.82 to 1.90). The impact
on DM appeared to be intermediate with atorvastatin 80 mg/day compared with placebo
(odds ratio 1.15, 95% credible interval 0.90 to 1.50). These findings were replicated at
moderate doses. In conclusion, different types and doses of statins show different potential
to increase the incidence of DM