Physicians' Academy for Cardiovascular Education

Canadian guidelines: statins advised at 40 for diabetics

News - Apr. 18, 2013

Canadian guidelines: statins advised at 40 for diabetics

New guidelines from the Canadian Diabetes Association (CDA) state that all patients with diabetes should start taking statins from the age of 40 and antihypertensives from the age of 55, even in the absence of other risk factors.
Patients older than 30 with diabetes since at least 15 years should also start on statins.
 
The new guidelines attempt to increase the number of patients with type 2 diabetes achieving all three targets in glucose, blood pressure, and LDL cholesterol control.
The recommendations from the CDA are substantially equal to the guidelines from the American Diabetes Association (ADA), though slightly more aggressive. ADA recommends statins for diabetics aged 40 and older who have at least one other risk factor. The ADA recommends antihypertensives  in diabetes patients with hypertension, microalbuminuria, or cardiovascular disease.
 
Another area in which the Canadian guidelines differ from their American counterpart is in the recommendation of using an HbA1c of 6% to 6.4% to diagnose pre-diabetes; ADA puts the cutoff lower, at 5.7%.
 
Many of these recommendations are based upon consensus, not solid evidence.
 
Source: Cheng A, et al "Clinical practice guidelines" 2013.
 

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