Statin Use With Diabetes | June 2020 | Clinical Corner

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Statin Use In Diabetics

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Statin Therapy for Patients with Diabetes - Download PDF Version

Adults 40–75 years of age with diabetes, who do or do not have clinical atherosclerotic cardiovascular disease (ASCVD), should be started on a statin for primary and secondary prevention of ASCVD regardless of lipid status.

 

Medications

One of the following medications must have been dispensed.

Note: The active ingredients are limited to oral formulations only.

Drug Category

Medications

Statin medications

· Lovastatin

· Fluvastatin

· Pravastatin

· Simvastatin

· Rosuvastatin

· Atorvastatin

· Pitavastatin

Statin combination products

· Atorvastatin / amlodipine

· Atorvastatin / ezetimibe

· Lovastatin / niacin

· Simvastatin / ezetimibe

· Simvastatin / niacin

· Simvastatin / sitagliptin

Standard exclusion(s)

Timeframe

· Patients in hospice

· End-stage renal disease (ESRD)

· Any time during the measurement year

· Any time during the measurement year or the year prior to the measurement
  • For diabetics without ASCVD, use MODERATE INTENSITY statin for primary prevention1.
  • For diabetics “with” ASCVD, use HIGH INTENSITY statin for secondary prevention2.
  • Low Intensity statins are not recommended unless unable to tolerate moderate or high intensity.

High-, Moderate-, and Low-Intensity Statin Therapy

High Intensity

Moderate Intensity

Low Intensity

Daily dose lowers LDL-C on average by ≈ ≥50%

Daily dose lowers LDL-C on average by ≈ 30% to <50%

Daily dose lowers LDL-C on average by <30%

Atorvastatin 40-80 mg

Rosuvastatin 20-40 mg

Atorvastatin 10-20 mg

Rosuvastatin 5-10 mg

Simvastatin 20-40 mg

Pravastatin 40-80 mg

Lovastatin 40 mg

Fluvastatin XL 80 mg

Fluvastatin 40 mg bid

Pitavastatin 2-4 mg

Simvastatin 10 mg

Pravastatin 10-20 mg

Lovastatin 20 mg

Fluvastatin 20-40 mg

Pitavastatin 1 mg

References:

  1. Cochrane Database Syst Rev. 2013:CD004816
  2. Diabetes Care 2006 Jun; 29(6): 1220-1226.

** Promote Statin Use in Diabetics **

If you have any questions, please contact Dr. Preston Thomas, Associate Medical Director at 248-484-4980 or [email protected]