Abstract
Evidence that patients with type 2 diabetes can benefit from statin therapy is strong. Issues remain to be resolved about whether all patients with type 2 diabetes should receive statin treatment. For the present the National Institute for Clinical Excellence has recommended statin treatment in secondary prevention and in primary prevention when coronary heart disease (CHD) risk exceeds 15% over the next 10 years or lipid levels are high. Fibrates are a better first-line drug therapy when triglycerides exceed 10 mmol/L. Consideration should also be given to combining a fibrate with a statin in patients with CHD whose triglycerides exceed 2.3 mmol/L despite statin treatment, but this requires careful monitoring for myositis. Clinical guidelines are needed for the use of lipid-lowering medication in type 1 diabetes.
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