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Statin use is associated with excess risk for new-onset diabetes with annual incidence ranging from a fraction of a percent with low-intensity statins to as high as 1.3% with high-intensity statins. But how lifestyle factors influence this risk is poorly understood. In this prospective study, investigators analyzed data from 300,000 U.S. Veterans Affairs patients (average age, 61) without diabetes or heart disease who were treated with statins. Patients were stratified by body–mass index (BMI), intensity of statin therapy, and cardiovascular fitness — defined based on peak metabolic equivalent achieved during stress testing at enrollment.
During average follow-up of 10 years, incidence of diabetes was 17 per 1000 patient-ye…