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Nat. Rev. Endocrinol. doi:10.1038/nrendo.2015.194 Figure 2 Potential sites of action of statins on β-cell function identified from in vitro studies Figure 2 | Potential sites of action of statins on β-cell function identified from in vitro studies. (1) Statins reduce mRNA and protein expression of GLUT2, limiting glucose uptake. (2) Statins upregulate LDL receptors and cholesterol uptake. Cholesterol loading impairs β-cell function, proliferation and survival. (3) Statins reduce Coenzyme Q10 (CoQ10) levels secondary to inhibition of the mevalonate pathway impairing mitochondrial electron transport and ATP production. ATP is an essential regulator of insulin secretion through effects on KATP channels, membrane depolarization and subsequent calcium channel opening. (4) Statins inhibit L-type calcium channels and the rise in cytosolic calcium levels that is required for insulin secretion. (5) Statins reduce isoprene synthesis impairing the post-translational modification of small G proteins, which are important in insulin-containing granule exocytosis. Reprinted from Sattar, N. & Taskinen, M. R. Statins are diabetogenic—myth or reality? Atheroscler. Suppl. 13, 1–10 (2012) © with permission from Elsevier. Betteridge, D. J. & Carmena, R. (2015) The diabetogenic action of statins — mechanisms and clinical implications Nat. Rev. Endocrinol. doi:10.1038/nrendo.2015.194