Both the 2017 American Diabetes Association (ADA) and the 2013 American College of Cardiology/American Heart Association (ACC/AHA) guidelines recommend that all patients with diabetes ages 40 to 75 receive statin therapy regardless of LDL cholesterol levels.

Both sets of guidelines recommend either high- or moderate-intensity statins depending on specific patient factors.^1,2

The ACC/AHA guidelines recommend a moderate-intensity statin for primary prevention in patients with diabetes mellitus and an LDL-C level of 70 ? 189 mg/dL. A high-intensity statin is recommended for this patient population if their ten-year atherosclerotic cardiovascular disease (ASCVD) risk is greater than 7.5 percent, a measure that is calculated using an online tool available through the ACC website.

In the event that a certain intensity statin is recommended but unable to be tolerated, a different statin or lower-intensity statin may be used in its place. There is evidence to suggest that statins provide benefits for diabetic patients, even at low less-than-daily doses.¹

Statin therapy for patients with cardiovascular disease risk factors

The United States Preventive Services Task Force recommends initiating a low- to moderate-dose statin in patients ages 40 to 75 with no history of cardiovascular disease (CVD), one or more CVD risk factors (dyslipidemia, diabetes, hypertension, or smoking), and a calculated ten-year CVD event risk of 10 percent or greater.³

In the event that a certain intensity statin is recommended but unable to be tolerated, a different statin or lower intensity statin may be used in its place.

Please note: This information is only current as of the date of publication.

¹American Diabetes Association. ?Standards of medical care in diabetes ? 2017.? Diabetes Care. January 2017; 40 Suppl 1:S79-81.

²Stone NJ, Robinson JG, Lichtenstein AH, Bairey Merz CN, Blum CB, Eckel RH, Goldberg AC, Gordon D, Levy D, Lloyd-Jones DM, McBride P, Schwartz JS, Shero ST, Smith SC Jr, Watson K, Wilson PW; American College of Cardiology/American Heart Association Task Force on Practice Guidelines. ?2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines.? J Am Coll Cardiol. 2014 Jul 1;63(25 Pt B):2889-934.

³Final Recommendation Statement: Statin Use for the Primary Prevention of Cardiovascular Disease in Adults: Preventive Medication. U.S. Preventive Services Task Force. November 2016. Available from: https://www.uspreventiveservicestaskforce.org/Page/Document/Reco mmendationStatementFinal/statin-use-in-adults-preventive-medication1. Accessed October 17, 2017.