Statins use may Increase Neuropathy risk Among T2DM patients, Metformin decreases it

Diabetic neuropathy is one of the most common chronic complications in patients with type 2 diabetes mellitus. It is a chronic microvascular complication in patients with T2DM that depends on the duration and severity of T2DM. Some observational studies have shown that statin and metformin were associated with an increased risk of neuropathy. However, little is known about the impact of commonly used medications, i.e. statins and metformin, on neuropathy development in patients with T2DM. Therefore, researchers of the Konkuk University Medical Center, Seoul KS013, South Korea, conducted a study to evaluate the incidence of neuropathy among patients with T2DM associated with statin and metformin therapies.

In the present study, the researchers used the Korean Health Insurance Review and Assessment patient sample data from 2016 and 2017. They included patients with T2DM (n=34964)and no complications (n=35887) were divided into statin/metformin/statin + metformin users and non-users.They determined neuropathy by the International Statistical Classification of Diseases and Related Health Problems, 10th revision codes and concomitant prescriptions for anticonvulsants or antidepressants. They used logistic regression analyses to examine the associations between statin/metformin/statin + metformin therapies and the incidence of neuropathy.

Key findings of the study:

• Upon analysis, the researchers found that statin therapy was associated with increased risks of neuropathy in 2016 and 2017 [PS-matched odds ratio (OR) = 1.22; PS-matched OR = 1.17].
• They also found that metformin therapy was associated with reduced risks of neuropathy in 2016 and 2017 (PS-matched OR = 0.30; PS-matched OR = 0.44).
• They found no significant association in combined statin + metformin therapy with neuropathy in 2016 or 2017 (PS-matched OR = 0.85; PS-matched OR = 0.95).

The authors concluded, "Statin therapy enhanced the risk of neuropathy in patients with T2DM, whereas metformin therapy reduced this risk. Combined statin + metformin therapy did not have a significant impact on the incidence of neuropathy. Therefore, when prescribing statin therapy for patients with T2DM, physicians should assess the potential for neuropathy development and consider the addition of metformin to reduce this risk."

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