Statement by the American Diabetes Association Regarding the American College of Cardiology/American Heart Association Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults
November 26, 2013
The American College of Cardiology (ACC) and the American Heart Association (AHA) recently released the 2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults. The American Diabetes Association (Association) recognizes the release of the new revised 2013 ACC/AHA Cholesterol Treatment Guidelines.
While select Association members participated in the process to develop the revised guideline, the guideline was not developed in collaboration with Association’s Professional Practice Committee, which develops the Association’s Clinical Practice Recommendations.
Members of the Association’s Professional Practice Committee plan to review the changes in the 2013 ACC/AHA Cholesterol Treatment Guidelines as they relate to patients with diabetes and prediabetes, and will determine if changes in the Association’s cholesterol management guidelines are warranted. However, such a thorough assessment could not be completed in a timely manner for the 2014 Standards of Care, but will be addressed in the 2015 Standards of Care.
There are underlying similarities and differences between the Association’s current Standards of Care and the revised 2013 ACC/AHA Cholesterol Treatment Guidelines. Both the Association and the ACC/AHA recognize the high prevalence, and morbidity and mortality of cardiovascular disease in patients with diabetes, and the importance of primary and secondary cardiovascular disease risk reduction in this population.
Both the current Association recommendations and the 2013 ACC/AHA Cholesterol Treatment Guidelines:
1) Emphasize the importance to well-being and cardiovascular risk reduction of lifestyle, healthy diet and exercise, and weight management, and;
2) Recognize the value of high intensity statin therapy added to lifestyle therapy for patients with diabetes and overt atherosclerotic CVD, regardless of baseline lipid levels.
The Association will consider whether moderate-dose statins should be used for the primary prevention in all patients 40-75 years of age with diabetes, regardless of baseline lipid levels or the presence of other cardiovascular risk factors. Notably, the revised 2013 ACC/AHA Cholesterol Treatment Guidelines de-emphasize lipid goal oriented treatment. Diabetes patients often have a unique pattern of dyslipidemia that may require specific consideration.
Additionally, there is no distinction between patients with type 1, type 2 or other forms of diabetes where there is less high quality data. Both the Association and the ACC/AHA recognize risk assessment as a process and that guidelines do not replace clinical judgment and patients’ circumstances in setting individualized goals and care for patients.
The Association encourages patients to consult their health care team, if they have questions about statin use.
The American Diabetes Association is leading the fight to Stop Diabetes and its deadly consequences and fighting for those affected by diabetes. The Association funds research to prevent, cure and manage diabetes; delivers services to hundreds of communities; provides objective and credible information; and gives voice to those denied their rights because of diabetes. For the past 75 years, our mission has been to prevent and cure diabetes and to improve the lives of all people affected by diabetes.