Denmark: Statin therapy does not mitigate or increase the risk of diabetic polyneuropathy (DPN) in type 2 diabetes (T2D) patients, according to a recent study in the journal Diabetes Care. However, during the first year, there was a slightly increased DPN risk among new users but it receded after >2 years of the study.
Owing to lipid-lowering and anti-inflammatory effects statins may reduce diabetic polyneuropathy (DPN) risk but also, their use has been associated with neurotoxicity. Frederik P. Kristensen, Department of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark, and colleagues examined whether statin therapy affects the risk of DPN.
The researchers identified all Danish patients with incident type 2 diabetes during 2002–2016. The initiation of statin in new users was done between 180 days before and 180 days after their first diabetes record. Prevalent users had initiated statins before that period. Patients were followed for incident diabetic polyneuropathy (DPN) using validated hospital diagnosis codes, starting 180 days after their first diabetes record
The study cohort consiaited of 59,255 (23%) new users, 75,528 (29%) prevalent users, and 124,842 (48%) nonusers; median follow-up time was 6.2 years.
Key findings of the study include:
The incidence rate of DPN events per 1,000 person-years was similar in new users (4.0), prevalent users (3.8) and nonusers (3.8).
The aHR for DPN was 1.05 in new users and 0.97 in prevalent users compared with statin nonusers.
New users had a slightly increased DPN risk during the first year (1.31), which vanished after >2 years of follow-up.
Findings were similar in on-treatment and propensity score-matched analyses and with additional adjustment for pretreatment blood lipid levels.
"Statin therapy is unlikely to increase or mitigate diabetic polyneuropathy (DPN) risk in patients with type 2 diabetes, although a small acute risk of harm cannot be excluded," concluded the authors.
"Statin Therapy and Risk of Polyneuropathy in Type 2 Diabetes: A Danish Cohort Study," is published in the journal Diabetes Care.
DOI: https://care.diabetesjournals.org/content/early/2020/09/29/dc20-1004