Metabolic & Cardiometabolic
statins increases new-onset type 2 diabetes
In plain terms: Do statins increase the risk of developing type 2 diabetes?
Part of: 💊 statins
Yes, a real but modest effect: meta-analyses show roughly a 9-12% relative increase in new-onset diabetes, dose-dependent, and far outweighed by cardiovascular benefit in indicated patients.
📅 Last reviewed: 2026-07-14 ⓘ
Evidence ladder
How far up the ladder this claim has climbed. A high consensus on a low rung means "consistent so far," not "proven in people."
Top evidence so far: All trials, pooled (Meta-analysis)
How the studies fall
What the evidence shows
Statins do raise new-onset type 2 diabetes, by roughly 9 to 12 percent in relative terms, dose-dependently: intensive versus moderate dosing carries an odds ratio of 1.12 across five trials in 32,752 people, and a 17-trial network meta-analysis agrees. The absolute risk is small and, in people who warrant a statin, outweighed by the cardiovascular benefit.
The evidence (11)
| Source | Grade | Stance | Quality | Finding |
|---|---|---|---|---|
| Lai KZH, Harris SB, Retnakaran R, Hanley AJG, Schwarz UI 2025 · The Journal of clinical endocrinology and metabolism | observational | supports | moderate | PROMISE longitudinal cohort (169/498 participants on statins, mainly rosuvastatin/atorvastatin, 9-year follow-up) found statin users had lower insulin sensitivity (5.3-6.4% reduction) and beta-cell function (4.9-7.6% reduction) versus non-u |
| Preiss D, Seshasai SR, Welsh P, Murphy SA, Ho JE, Waters DD, DeMicco DA, Barter P, Cannon CP, Sabatine MS, Braunwald E, Kastelein JJ, de Lemos JA, Blazing MA, Pedersen TR, Tikkanen MJ, Sattar N, Ray KK 2011 · JAMA | meta-analysis | supports | high | Meta-analysis of 5 trials (32,752): intensive-dose vs moderate-dose statins raised new-onset diabetes (OR 1.12), establishing dose-dependence of the diabetes signal. |
| Lin JL, Hsu C, Lo SW, Nigam N, Shenoi M, Tu YF, Bhanderi H, Chen CC, Su YJ, Chang HC, Gau SY 2026 · Diabetes/metabolism research and reviews | observational | supports | moderate | Target-trial-emulation propensity-matched cohort (TriNetX) found PCSK9 inhibitors had significantly lower incident-T2DM risk than statins (HR 0.815, 95% CI 0.764-0.869) among hyperlipidemia patients. Using statins as the higher-risk active |
| Navarese EP, Buffon A, Andreotti F, Kozinski M, Welton N, Fabiszak T, Caputo S, Grzesk G, Kubica A, Swiatkiewicz I, Sukiennik A, Kelm M, De Servi S, Kubica J 2013 · Am J Cardiol | meta-analysis | supports | high | Network meta-analysis of 17 RCTs (113,394 patients) found statins increased new-onset diabetes in a type- and dose-dependent manner (highest with rosuvastatin/atorvastatin). |
| Li W, Wang D, Lin C, Cai T, Zhao M, Liang L, Zhao X, He X, Liang X, Zheng J 2025 · Cardiovasc Drugs Ther | meta-analysis | tested-null | moderate | Meta-analysis of statin adverse reactions across diseases quantified new-onset diabetes among the significant class effects. |
| Thakker D, Nair S, Pagada A, Jamdade V, Malik A 2016 · Pharmacoepidemiol Drug Saf | meta-analysis | supports | moderate | Network meta-analysis of RCTs confirmed a significant association between statin therapy and incident diabetes. |
| Sattar N, Preiss D, Murray HM, Welsh P, Buckley BM, de Craen AJ, Seshasai SR, McMurray JJ, Freeman DJ, Jukema JW, Macfarlane PW, Packard CJ, Stott DJ, Westendorp RG, Shepherd J, Davis BR, Pressel SL, Marchioli R, Marfisi RM, Maggioni AP, Tavazzi L, Tognoni G, Kjekshus J, Pedersen TR, Cook TJ, Gotto AM, Clearfield MB, Downs JR, Nakamura H, Ohashi Y, Mizuno K, Ray KK, Ford I 2010 · Lancet | meta-analysis | supports | high | Collaborative meta-analysis of 13 trials (91,140 participants): statins raised new-onset diabetes 9% (OR 1.09); ~1 extra case per 255 patient-years — modest and outweighed by CV benefit. |
| Ridker PM, Danielson E, Fonseca FA, Genest J, Gotto AM, Kastelein JJ, Koenig W, Libby P, Lorenzatti AJ, MacFadyen JG, Nordestgaard BG, Shepherd J, Willerson JT, Glynn RJ, JUPITER Study Group 2008 · N Engl J Med 2008 Nov 20;359(21):2195-2207 | RCT | supports | moderate | JUPITER (n=17,802, rosuvastatin 20 mg vs placebo, median 1.9 y): the rosuvastatin group 'did not have a significant increase in myopathy or cancer but did have a higher incidence of physician-reported diabetes'. Unadjudicated, physician-reported safety outcome; the abstract reports no count, effect size or p-value for diabetes. |
| Park EJ, Park Y, Kang DO, Park S, Roh SY, Na JO, Kim JW, Kim EJ, Rha SW, Park CG, Choi CU 2026 · Frontiers in cardiovascular medicine | observational | supports | low | Korean NHIS cohort of 29,826 ASCVD patients on secondary-prevention statins found 40% developed new-onset diabetes over 5 years, with rosuvastatin (HR 1.07), pravastatin (HR 1.19) and simvastatin (HR 1.15) showing higher risk than atorvasta |
| Albawa'neh AS, Alqasrawi MN, Al-Mahayri ZN, Albawaana A, Ahmed G, Al-Rifai RH, Ali BR 2025 · Ann Med | meta-analysis | mixed | low | Systematic review noting statins increase new-onset T2DM while assessing ezetimibe; an independent contemporary confirmation of the statin-diabetes signal. |
| Naci H, Brugts J, Ades T 2013 · Circ Cardiovasc Qual Outcomes | meta-analysis | supports | high | Study-level network meta-analysis of 135 RCTs (246,955 participants) found statins as a class raised diabetes risk, with heterogeneity between individual agents. |
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