CYP3A4 downregulation due to T2DM could result in less atorvastatin lactone clearance thus forcing it to equilibrium with the acid form, which could lead to a higher risk of 3-hydroxy-3-methyl-glutaryl-CoA reductase (HMG-CoA reductase) inhibitor (statin)-induced myotoxicity. This evidence concerns the gene CYP3A4 and type 2 diabetes mellitus.