In the April 20 issue of the Annals of Internal Medicine, the American College of Physicians has published new clinical guidelines on how to deal with lipids in patients with type II diabetes.
They recommend the routine use of statins in diabetics with known coronary artery disease, regardless of their blood cholesterol levels. They also recommend routine statin use in type II diabetics who have at least one additional risk factor for cardiovascular disease, such as hypertension, smoking, or age over 55 years. Finally, citing large, well-conducted trials pointing out that statins are "extremely safe," they do not recommend routinely monitoring liver function tests or muscle enzymes.
The authors note that while statins are used primarily to reduce cholesterol levels, they seem to provide cardiovascular protection over and above mere lipid lowering. While most cardiologists are aware of the data supporting statin use, the authors hope the new ACP guidelines will increase this awareness among the internists and family doctors who care for patients with type II diabetes before they develop heart disease.
