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Objective To evaluate the incremental increase in new onset diabetes from higher potency statins compared with lower potency statins when used for secondary prevention.

Design Eight population based cohort studies and a meta-analysis.

Setting Six Canadian provinces and two international databases from the UK and US.

Participants 136 966 patients aged ≥40 years newly treated with statins between 1 January 1997 and 31 March 2011.

Methods Within each cohort of patients newly prescribed a statin after hospitalisation for a major cardiovascular event or procedure, we performed as-treated, nested case-control analyses to compare diabetes incidence in users of higher potency statins with incidence in users of lower potency statins. Rate ratios of new diabetes events were estimated using conditional logistic regression on different lengths of exposure to higher potency versus lower potency statins; adjustment …