New Diabetic Guidelines

There are important new diabetes guidelines just released that instruct most Type 2 diabetics to take cholesterol-lowering medication. The goal is to cut down on their risk for heart attacks and strokes, common killers in this patient population. Now, these new diabetes guidelines put out by the American College of Physicians, say most diabetics need to be put on cholesterol lowering medicines even if their cholesterol levels are not high.

Specifically, the guidelines say statin drugs--medications like Zocor, Lipitor, and Pravachol, should be prescribed to any diabetic with another coronary risk factor. These major risk factors include high blood pressure, tobacco use, being male and aged over 55.

The guidelines also say that any diabetic who has a history of coronary artery disease should be on this type of cholesterol-lowering medication. The guidelines did not say whether any one statin is better than another.

Diabetes in itself is a tremendous risk factor for heart attacks and strokes. 80% of Type Two diabetics will develop or die from some form of vascular disease. Add on another risk factor, say, high cholesterol, and that risk is significantly increased. Dr. Elise Brett, an endocrinologist and diabetic specialist in New York says, "Treatment of cholesterol abnormalities and blood pressure in patients with diabetes is actually more important than treating the blood sugar in terms of lowering risk for cardiovascular events." Dr. Brett looks closely every time she examines her patient Leslie Granger. "She found that my cholesterol was high. And she put me first of all on Lipitor." Leslie reports. "If she says it's high, it's time to do something about it." But the question is, how low should the cholesterol go? All the guidelines say is that once the medication is started, the diabetic should be taking at least moderate doses of the statin drug.

"Current treatment guidelines suggest that an LDL in a diabetic patient should be under 100. But we don't know how low is low enough yet. If a patient has had a coronary event with an LDL under 100, their LDL probably needs to be lower than that" advises Dr. Brett. "We need to be very aggressive about treating cholesterol in diabetic patients to prevent heart attacks."For diabetics like Leslie, watching their cholesterol according to the new diabetes guidelines may help them live longer and healthier lives."I'm 59 and hopefully I have another 30 years to live."

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