Diuretics, β-blockers, and statins in increasing the risk of diabetes HD

Read the full article online: http://www.bmj.com/content/347/bmj.f6745 The use of β blockers, diuretics, and statins has been established to reduce cardiovascular morbidity and mortality in a variety of diseases.However, although statins reduce cardiovascular events and mortality in patients with coronary artery disease or equivalent risk factors, debate continues about their role in primary prevention in lower risk populations. Despite the overwhelming benefits of these drugs on cardiovascular outcomes, recent evidence suggests that long term use may increase the risk of diabetes. Large trials examining cardiovascular outcomes and mortalities suggested an increased incidence of new onset diabetes with long term use of diuretics. Likewise, other studies have reported an increased incidence of diabetes in people treated with statins, prompting the US Food and Drug Administration to release a safety label change in 2012. Furthermore, β blockers have been implicated in impaired glucose metabolism, especially with diuretics. Large scale studies with serial glucose measurements examining the association between these drugs and new onset diabetes in patients with impaired glucose tolerance are limited. We reanalysed data from the Nateglinide and Valsartan in Impaired Glucose Tolerance Outcomes Research (NAVIGATOR) study to examine the relation between risk of new onset diabetes and use of β blockers, thiazide diuretics, or statins in treatment naïve patients. In this study, the researchers set out to examine the degree to which use of β blockers, statins, and diuretics in patients with impaired glucose tolerance and other cardiovascular risk factors is associated with new onset diabetes.