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Reducing Cardiac Risk: Prescribing Statins for Patients with Diabetes

Posted August 6, 2020

Having diabetes means worrying about more than blood glucose. It’s a disease with multiple risk factors, including cardiovascular risks. In 2017, the American Diabetes Association (ADA) issued a recommendation regarding diabetes and cholesterol-lowering statins.1

Statins are most commonly associated with heart disease. However, diabetes increases the likelihood someone may develop heart disease. This means your patients with diabetes may also benefit from statins. The American College of Cardiology (ACC) and the American Heart Association (AHA) expanded the number of potential statin users to include patients with diabetes.2

Some of the diabetes risk factors statins may help manage include:

  • High cholesterol
  • Coronary artery disease
  • Elevated risk of heart attack
  • Elevated risk of stroke

Statins are usually prescribed for:

  • Heart disease
  • LDL cholesterol level of 190 mg/dL or higher
  • Diabetes and an LDL of 70 mg/dL or higher
  • A 10-year heart attack risk of 7.5% or higher and an LDL of at least 100 mg/dL
  • Individuals aged 40 to 75 years old with diabetes, regardless of LDL levels

Statin Use for Persons with Diabetes (SUPD): A Recent Part D Measure2
The designation SUPD is a quality measure relating to cardiovascular disease and was endorsed by the Pharmacy Quality Alliance in 2014. In 2017, the Centers for Medicare & Medicaid Services (CMS) adopted this as a Star Rating measure. The measure is defined as the percent of Medicare Part D beneficiaries 40 to 75 years old who were dispensed at least two diabetes medication fills and who received a statin medication fill during the measurement period.3

Statins, effective and well-tolerated, have been linked to better cardiovascular health. For diabetes patients aged 40 to 75 years old, ACC/AHA guidelines suggest moderate-to-high-intensity statin therapy for primary prevention. In tandem with positive lifestyle change, it’s another tool to help patients manage their diabetes.2

Communication is Key
Including our members, your patients, in the discussion process is critical to helping provide quality care. If a statin is prescribed, talk with them about why the statin is important, their LDL cholesterol levels, statin side effects and how they may respond to them. It may help make living with diabetes easier. 

1American College of Cardiology, The New 2017 American Diabetes Statement on Standards of Medical Care in Diabetes: Reducing Cardiovascular Risk in Patients with Diabetes, May 22, 2017. https://www.acc.org/latest-in-cardiology/articles/2017/05/22/11/00/new-2017-american-diabetes-statement-on-standards-of-medical-care-in-diabetes

22013 ACC/AHA Prevention 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. Circulation. 2014;129:S1-S45, June 24, 2014. https://www.ahajournals.org/doi/pdf/10.1161/01.cir.0000437738.63853.7a

3CMS, 2019 Medicare-Medicaid Plan Performance Data Technical Notes. https://www.cms.gov/Medicare-Medicaid-Coordination/Medicare-and-Medicaid-Coordination/Medicare-Medicaid-Coordination-Office/FinancialAlignmentInitiative/Downloads/MMPPerformanceDataTechNotes.pdf

The above material is for informational purposes only and is not a substitute for the independent medical judgment of a physician or other health care provider. Physicians and other health care providers are encouraged to use their own medical judgment based upon all available information and the condition of the patient in determining the appropriate course of treatment. References to third party sources or organizations are not a representation, warranty or endorsement of such organizations. Any questions regarding those organizations should be addressed to them directly. The fact that a service or treatment is described in this material is not a guarantee that the service or treatment is a covered benefit and members should refer to their certificate of coverage for more details, including benefits, limitations and exclusions. Regardless of benefits, the final decision about any service or treatment is between the member and their health care provider