Premium
Statins for people with type 1 diabetes: when should treatment start?
Author(s) -
Fisher Miles
Publication year - 2016
Publication title -
practical diabetes
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.205
H-Index - 24
eISSN - 2047-2900
pISSN - 2047-2897
DOI - 10.1002/pdi.1990
Subject(s) - medicine , guideline , type 2 diabetes , evidence based medicine , statin , family medicine , disease , systematic review , diabetes mellitus , medline , evidence based practice , alternative medicine , randomized controlled trial , intensive care medicine , physical therapy , pathology , endocrinology , political science , law
systematically developed statements to assist practitioners and patients about health care for specific clinical circumstances. The evidence base should be obtained using an unbiased and transparent process of systematically reviewing, and appraising published clinical research, which is then synthesised into recommendations for clinical practice. There is a hierarchy of evidence, from meta-analyses or systematic reviews of randomised controlled trials, through case control or cohort studies, to expert opinion. Evidence-based guidelines have largely replaced consensus statements, where a group of experts would meet and produce a series of recommendations based on the consensus of the group. A large evidence base supports the use of statins in people with type 2 diabetes, but there is very limited evidence for the use of statins in people with type 1 diabetes.1 A NICE guideline on the modification of lipids for the primary and secondary prevention of cardiovascular disease was published in 2014.2 This recommends considering statin treatment for the primary prevention of cardiovascular disease in all adults with type 1 diabetes, and recommends offering statin treatment to adults with type 1 diabetes who are older than 40 years of age, or who have had diabetes for more than 10 years, or who have established nephropathy, or other cardiovascular risk factors. It also recommends starting treatment with atorvastatin 20mg. Is there any the evidence behind these recommendations, and are these recommendations truly evidence based or another consensus statement from a group of experts?