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.