Why statin therapy is important in your patients with diabetes

Why it matters:

• Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of morbidity and mortality in individuals with diabetes.
• The 2019 ACC/AHA* guidelines recommend statin therapy for primary prevention of ASCVD in patients with diabetes mellitus, aged 40 to 75 years, regardless of estimated 10-year ASCVD risk.
• Statins are generally well-tolerated and safe drugs.
• Benefits of lowering LDL-C with statins far outweigh the likelihood of an adverse effect for most adults at elevated risk for ASCVD and secondary events.

* ACC/AHA- American College of Cardiology and American Heart Association

Did you know?  

• Just over 50% of US adults who would benefit from cholesterol-lowering medications are taking them.
• Reducing LDL-C levels with statins by ~39 mg/dL can reduce heart disease and stroke risk by ~21%

Best practices:

• Educate patients on increased risk of cardiovascular disease to understand the benefits of statins.

• Once stable on therapy, prescribe 90-day supply to prevent refill gaps in therapy.  
• Consider home delivery through *CarelonRx Mail to avoid long waits at the pharmacy and minimize transportation barriers.  
• If statin side effects occur, consider strategies to mitigate them while continuing a statin: 

• Lower the dose. 
• Intermittent dosing with rosuvastatin may benefit patients with previous statin intolerances. 
• Try a brief period of discontinuation, then re-challenge with the same or different statin. 

Statin formulary medications 

Note: Both pitavastatin (Livalo) 1 to 4 mg and fluvastatin 40 mg BID qualify as moderate-intensity; however, Livalo is non-formulary and fluvastatin is a more expensive agent with member copay (Tier 3 or 4).