In the JournalsPerspective

Statin therapy linked to decreased risk of diabetic retinopathy

Statin therapy was shown to be associated with a decreased risk of diabetic retinopathy in patients with type 2 diabetes and dyslipidemia, according to a study published in JAMA Ophthalmology.

The population-based cohort study used the National Health Insurance Research Database to identify patients with type 2 diabetes and dyslipidemia.

A total of 219,359 Taiwanese patients were selected for the study. Of these patients, 199,760 were in the statin group and 19,599 were in the non-statin group and after propensity score matching, 18,947 patients were analyzed in each group.

Researchers evaluated the exposure period to measure the medication possession rate for the statin. A medication possession rate of 80% or higher was required for the statin group.

“Statin frequency and dosage were obtained, and the intensity for each statin was calculated as low, moderate or high intensity according to the 2013 American College of Cardiology/American Heart Association guideline,” Eugene Yu-Chuan Kang, MD, researcher at the Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou Medical Center, and colleagues wrote.

Statin therapy was shown to be associated with a decreased risk of diabetic retinopathy in patients with type 2 diabetes and dyslipidemia, according to a study published in JAMA Ophthalmology.

The population-based cohort study used the National Health Insurance Research Database to identify patients with type 2 diabetes and dyslipidemia.

A total of 219,359 Taiwanese patients were selected for the study. Of these patients, 199,760 were in the statin group and 19,599 were in the non-statin group and after propensity score matching, 18,947 patients were analyzed in each group.

Researchers evaluated the exposure period to measure the medication possession rate for the statin. A medication possession rate of 80% or higher was required for the statin group.

“Statin frequency and dosage were obtained, and the intensity for each statin was calculated as low, moderate or high intensity according to the 2013 American College of Cardiology/American Heart Association guideline,” Eugene Yu-Chuan Kang, MD, researcher at the Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou Medical Center, and colleagues wrote.

    Perspective
    Harry Green

    Harry Green

    Although often thought of as an isolated clinical entity, diabetes mellitus is cardiovascular disease at its core. Naturally, treatment of common comorbidities that occur in individuals with type 2 diabetes mellitus, such as hyperlipidemia, could very well prove key to optimally managing the disease. With the power of “big data,” this paper uses a large body of clinical data from a nationalized health care system to carefully match two groups of type 2 diabetics: those that received statin therapy and those that did not. The results are compelling, with significant decreases in the development of all forms of diabetic retinopathy, the need for surgical intervention of vision-threatening diabetic retinopathy and the development of other major diabetic complications in patients that received statin treatment.

    The study is limited, however, in that it is a retrospective analysis of multivariable clinical data that it is limited to a single ethnicity. In contrast, prospective randomized studies have not been able to show a definite benefit to statin therapy in type 2 diabetes mellitus patients, and the question remains an open one. Further investigation is needed before clinicians can be confident in the utility of statins as adjunct therapy in the treatment of type 2 diabetes.

    • Harry Green, OD, PhD, FAAO
    • Assistant clinical professor, University of California Berkeley School of Optometry
      Director, UC Berkeley Digital Health

    Disclosures: Green reports he is a consultant to Rimokon Inc.