For people with HIV with low-to-moderate atherosclerotic cardiovascular disease (ASCVD) risk, metabolic risk factors contribute to new-onset diabetes mellitus (DM) among those treated with statin or placebo, according to a study published in Annals of Internal Medicine. Steven Grinspoon, MD, and colleagues examined the contribution of known DM risk factors to excess risk for DM with statin use among people with HIV in REPRIEVE. The researchers included 7,731 people with HIV aged 40 to 75 who had a low-to-moderate risk for ASCVD and did not have DM, they randomly assigned these participants to receive either 4 mg of a statin daily or a placebo in a 1:1 ratio. In each treatment group, participants with at least three DM risk factors versus no risk factors had an increased risk for DM (incidence rate, 3.24 vs 0.34 per 100 person-years in the statin group and 2.66 vs 0.27 per 100 person-years in the placebo group). In adjusted analyses, the researchers found that high BMI, prediabetes, and components of metabolic syndrome were strongly associated with new-onset DM.