In this issue of the Archives, Culver et al report an association between use of statins and increased risk of developing diabetes mellitus in a large cohort of women enrolled in the Women's Health Initiative. These data confirm and extend associations previously demonstrated among participants in randomized trials. Although observational data are potentially susceptible to bias by indication, we thought it was noteworthy that the increased risk of diabetes mellitus with statin use was similar among women with and without a history of cardiovascular disease, a finding that may have important implications for the balance of risk and benefit of statins in the setting of primary prevention in which previous meta-analyses show no benefit on all-cause mortality.
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