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Defeat Diabetes Foundation

Defeat Diabetes
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Statins Urged for Diabetic Patients

Posted: Thursday, May 12, 2005

The American Diabetes Association recommendations state that diabetics who are older than 40 years of age whose total cholesterol exceeds 3.5 mmol/L (135 mg/dL) should be placed on statin therapy to achieve a 30% to 40% reduction in LDL level, regardless of their baseline LDL level and even if they do not have overt cardiovascular disease.

In the Pravastatin or Atorvastatin Evaluation and Infection Therapy-Thrombolysis in Myocardial Infarction (PROVE-IT) study, treatment with atorvastatin 80 mg/day lowered LDL cholesterol levels to a median of 1.6 mmol/L (62 mg/dL) in diabetics and nondiabetics alike, compared to 2.5 mmol/L (97 mg/dL) with the standard pravastatin40-mg regimen.
Among patients taking atorvastatin, the hazard ratio for a cardiovascular event was 16% less than it was for patients on pravastatin after the mean follow-up period of 24 months, a significant difference (Cannon C. et al. N Engl J Med 2004;350:1495-1504).

Dr. Betteridge urged physicians to follow the recommendations in the Third Report of the Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults released by the U.S. National Cholesterol Education Program. This panel established a goal LDL cholesterol level of <1.8 mmol/L (<69 mg/dL) for patients with diabetes and cardiovascular disease, regardless of their baseline LDL cholesterol level.

"The message is, the lower the LDL the better, particularly in our patients with diabetes," he said. Raising the high-density lipoprotein (HDL) cholesterol level also seems to help reduce cardiovascular risk in diabetics, Dr. Betteridge said.

Further analysis in this study showed that diabetic patients benefited as much as nondiabetics from the drug intervention, Dr. Betteridge said.

Source: Diabetes In control.com: