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Type 2 diabetes: in some patients, statin therapy reduces cardiovascular risk

Statin cholesterol-lowering therapy reduces the cardiovascular risk in some type 2 diabetes patients. It should not be routinely prescribed and it is important to take into account the adverse effects of statins, the patient’s cholesterol level and the presence of other risk indicators.

The use of some statins (cholesterol-lowering agents) reduces the risk of coronary events in case of hypercholesterolemia and coronary disease in patients with ischaemic artery disease.

In type 2 diabetics with cardiovascular complications, statin therapy prevents just under two coronary events per year per 100 patients treated.

In type 2 diabetics without cardiovascular complications, statins should not be routinely prescribed. Several factors need to be taken into account: the adverse effects of statins, especially muscular, the level of LDL cholesterol, and the presence of cardiovascular risk indicators, especially arterial hypertension.

Simvastatine is the best evaluated statin, both in type 2 diabetes patients and in non-diabetics. This treatment is combined with dietary precautions and other preventive measures: hyperglycaemia and hypertension treatments in particular.

©Prescrire July 2005

Source: "Diabète de type 2 : une statine pour certains patients. Tenir compte des indicateurs de risque cardiovasculaire, et préférer la simvastatine" Rev Prescrire 2005 ; 25 (263) : 520-524.

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