Rationale for new American Diabetes Association Guidelines: are national cholesterol education program goals adequate for the patient with diabetes mellitus?

Am J Cardiol. 2005 Aug 22;96(4A):33E-36E. doi: 10.1016/j.amjcard.2005.05.012.

Abstract

Both the American Diabetes Association (ADA) and the National Cholesterol Education Program (NCEP) consider type 2 diabetes mellitus to be a coronary artery disease (CAD) risk equivalent and thus suggest that patients with either diabetes or CAD should have their plasma levels of low-density lipoprotein (LDL) cholesterol lowered to <2.59 mmol/L (<100 mg/dL). Recently the NCEP issued a white paper suggesting an even lower plasma LDL cholesterol goal of <1.81 mmol/L (<70 mg/dL) for patients at high cardiovascular risk, including patients with diabetes. This rationale was based partly on the higher risk of future cardiovascular disease seen in patients who have diabetes with or without preexisting cardiovascular disease than in nondiabetic subjects with preexisting cardiovascular disease. Additionally, as reported in the Pravastatin or Atorvastatin Evaluation and Infection Therapy (PROVE-IT) study, high-dose lipid-lowering therapy has been shown to further reduce CAD event rates compared with conventional therapy.

Publication types

  • Review

MeSH terms

  • Cholesterol, LDL / blood
  • Controlled Clinical Trials as Topic
  • Coronary Artery Disease / etiology
  • Coronary Artery Disease / prevention & control*
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / complications
  • Diabetes Mellitus, Type 2 / drug therapy*
  • Humans
  • Hyperlipidemias* / complications
  • Hyperlipidemias* / drug therapy
  • Hypolipidemic Agents / therapeutic use
  • Patient Education as Topic / standards*
  • Practice Guidelines as Topic
  • Risk Factors
  • Societies, Medical
  • United States

Substances

  • Cholesterol, LDL
  • Hypolipidemic Agents