Can Diuretics, Statins, and Beta Blockers Increase Diabetes Risk?

In an analysis of the NAVIGATOR study, patients who already had an impaired glucose tolerance at the beginning of the trial were shown to have…. 

This study looked at study participants who were currently naïve to beta blockers (n=5640), statins (n=6146), or diuretics (n=6346) at the beginning of the NAVIGATOR trial. In order to have a control which was metabolically neutral, this trial also looked at study participants who were not initially taking calcium channel blockers (n=6294). Some of these participants were then started on these medications and their risk for developing diabetes was compared to those who were not at the 5 year follow up. At the five year follow up beta blockers had been started in 915 of the previously naïve patients, diuretics were started in 1316 of the patients, statins were started in 6146 of the patients, and calcium channel blockers in 1171 patients.

It was discovered that the patients who had been started on diuretics or statins had a greater risk of developing diabetes by the 5 year follow up period (hazard ratio 1.23, 95% confidence interval 1.06 to 1.44, and 1.32, 1.14 to 1.48, respectively). While the patients who had been newly started on beta blockers or calcium channel blockers did not have an increased risk of developing diabetes at the five year follow up (1.10, 0.92 to 1.31, and 0.95, 0.79 to 1.13, respectively).

This study suggests that for patients who are already at risk of developing diabetes due to having an impaired glucose tolerance, the risk versus benefit of starting a statin or a diuretic should be looked at closely. In those who do require these medications, it would be prudent to encourage patients to take steps to lessen their risks of developing diabetes such as improving their diet or beginning a regular exercise routine.

• A reanalysis of the previous NAVIGATOR trial found that beginning diuretic or statin therapy in patients with an impaired glucose tolerance led to a greater risk of developing diabetes than those who were not started on these medications.
• Beginning a beta blocker or a calcium channel blocker in patients with an impaired glucose tolerance was found to have no increased risk of developing diabetes compared to patients who did not begin these medications.
• When starting patients with an impaired glucose tolerance on a diuretic or a statin, encourage them to make healthy lifestyle changes in order to avoid developing diabetes.