Statin Glycemic Risk
Project how much a statin will increase your HOMA-IR and new-onset diabetes (NODM) risk, using pooled data from Sattar 2010, Preiss 2011, and the 2024 Lancet CTT meta-analysis. Compares five statins side-by-side.
Patient Parameters
Normal <5.7% · Prediabetes 5.7–6.4% · Diabetes ≥6.5%
Statin Regimen
Enter patient parameters and statin regimen, then tap Calculate.
Overall Glycemic Risk
–HOMA-IR Trajectory
Cumulative NODM Risk Over Time
Result Interpretation
Alternative Statins
Cardiovascular benefit vs glycemic cost, get it right for you.
Statins are among the most effective cardiovascular preventives we have. For most people, that benefit still outweighs the diabetes risk. But the tradeoff depends on your cardiac risk, your metabolic baseline, and your timeline. A full workup lets you make that call with real data.
Evidence & Sources
- Sattar N, Preiss D, Murray HM, et al. Lancet. 2010;375(9716):735-742. Statins and risk of incident diabetes: collaborative meta-analysis of randomised statin trials.
- Preiss D, Seshasai SRK, Welsh P, et al. JAMA. 2011;305(24):2556-2564. Risk of incident diabetes with intensive-dose compared with moderate-dose statin therapy.
- Carter AA, Gomes T, Camacho X, et al. BMJ. 2013;346:f2610. Risk of incident diabetes among patients treated with statins: population based study.
- Casula M, Mozzanica F, Scotti L, et al. Pharmacol Res. 2017;120:186-193. Statin use and risk of new-onset diabetes: a meta-analysis of observational studies.
- Crandall JP, et al. J Endocr Soc. 2020. Statin use associated with HOMA-IR in CaMos cohort.
- Mach F, et al. Eur Heart J. 2023. Effects of statin therapy on glycemic control and insulin resistance (MD HOMA-IR +0.49).
- CTT Collaboration. Lancet Diabetes Endocrinol. 2024. Effects of statin therapy on diagnoses of new-onset diabetes, CTT meta-analysis.
Clinical Disclaimer: This tool generates statistical estimates based on published meta-analysis averages and is intended for educational and clinical decision-support purposes only. Individual risk will vary based on genetics, lifestyle, comorbidities, and other medications. Cardiovascular benefits of statin therapy must be weighed against glycemic risks for each patient. This tool does not substitute for individualized clinical judgment.
About Statin Glycemic Risk
Do statins really cause diabetes?
Yes, modestly. Meta-analysis of randomized trials (Sattar 2010, Preiss 2011) found that statins raise the risk of new-onset diabetes by about 9–13% on moderate doses and ~36% on high-intensity doses. That's a relative increase; the absolute increase is typically 1–3 extra cases per 100 people over 4–5 years.
Is the cardiovascular benefit worth it?
For most high-risk people, yes, by a lot. Statins prevent several times more cardiovascular events than the diabetes cases they cause. But the ratio changes based on your cardiac risk. In someone with high 10-year CHD risk, the math favors the statin strongly. In someone with low cardiac risk and high metabolic risk, the tradeoff is tighter and other options (diet, ezetimibe, bempedoic acid, PCSK9) may be worth discussing.
Which statin is best for metabolic risk?
Pitavastatin has the lowest glycemic impact in the published data (effectively neutral on HOMA-IR), followed by pravastatin. High-intensity rosuvastatin has the largest glycemic impact. The calculator ranks all five so you can see the tradeoff in your numbers.
Will my HOMA-IR definitely go up?
Meta-analysis averages predict roughly a 0.4–0.7 unit increase in HOMA-IR on a moderate-intensity statin. Your individual response can vary, some people see no change, some see more. A fasting insulin + glucose check 3 months after starting is the cleanest way to measure your actual effect.
What can I do to offset statin glycemic effects?
The same levers that lower baseline HOMA-IR work while on a statin: resistance training, sleep ≥ 7h, reduced carbohydrate load, post-meal walks. Metformin is sometimes added if a high-intensity statin is medically necessary and glycemic risk is elevated.