Are the New Guidelines for Lipids Appropriate for People with Diabetes?

The new guidelines divide patients into four groups for whom statin treatment is recommended: individuals with cardiovascular disease; individuals with LDL cholesterol (LDL-C) levels higher than 190 mg/dL; individuals with diabetes, between the ages of 40-75, with LDL-C levels 70-189 mg/dL; and individuals without diabetes or cardiovascular disease, with LDL-C 70-189 mg/dL, and an estimated risk of cardiovascular disease greater than 7.5%. There are no specific target levels for lowering cholesterol, only the recommendation that statins be used to reduce it. Under the new guidelines, the vast majority of people with type 2 diabetes would be recommended for statin therapy. The ADA recommends that people with diabetes keep LDL-C levels at or below 100 mg/dL, or under 70 mg/dL if they also have cardiovascular disease. See this week’s Item #4.