Taking statins or having a specific gene version makes people gain a little bit of weight and get a slightly bigger waist, even if they don’t eat more — this is because blocking the HMGCR enzyme affects how the body stores fat.

Even high-dose statins don’t make you gain more weight than low-dose ones — but they still raise your diabetes risk more — meaning weight gain isn’t the reason higher doses are riskier.

Blocking the HMGCR enzyme — whether by statin drugs or your genes — makes you about 11–12% more likely to develop type 2 diabetes, and this isn’t because the drugs lower cholesterol.

Even though statins make you gain a little weight, that tiny gain can’t explain why you’re 11% more likely to get diabetes — something else about blocking HMGCR is making your body worse at handling sugar.

People with a gene version that blocks HMGCR have slightly higher blood sugar and insulin levels — meaning their bodies are less efficient at managing sugar, even before they become diabetic.

HMG-CoA reductase inhibition with statins modestly increases the risk of developing type 2 diabetes, particularly in individuals with pre-existing insulin resistance.