Statins for Primary Prevention in Diabetes Mellitus Type 2german translation / full article
Should all patients with type 2 diabetes mellitus be treated with a statin in primary cardiovascular prevention? The German National Guideline on the treatment of diabetes mellitus type 2 remains vague regarding this issue. What is current best evidence regarding the prescription of statins for patients with diabetes mellitus type 2 in primary prevention of cardiovascular disease?
Current best evidence points at a reduction of cardiovascular events of 20–25 % by statins in patients with diabetes mellitus in primary prevention. So far, this effect could only be shown for patients with an initial risk of 20 % in 10 years. A significant reduction of all-cause mortality could not be demonstrated. The calculation of total initial risk with the risk calculators currently available is characterized by uncertainty. The primary care physician will therefore have to make individualized decisions together with the patient in a shared decision making process.