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Lipid management in patients with diabetes mellitus

Key principles of lipid management (LDL-C in particular) in accordance with the 2019 ESC/EAS Guidelines for the management of dyslipidaemias, and the 2023 ESC guidelines for the management of cardiovascular disease in patients with diabetes.

Cardiovascular disease (CVD) is responsible for >4 million deaths in Europe each year. The 2019 ESC/EAS Guidelines for the management of dyslipidaemias define those with documented ASCVD, type 1 or type 2 diabetes mellitus, very high levels of individual risk factors, or chronic kidney disease (CKD) as very-high CV risk.1

guidelines

In very-high CV risk patients, the 2019 ESC/EAS dyslipidaemia guidelines recommend:1

These patients require pharmacological intervention alongside lifestyle management to help reach targets.1

Intensity of lipid lowering treatment

The 2023 ESC Guidelines for the management of cardiovascular disease in patients with diabetes outline the same underlying principles for the management of dyslipidaemia, with the addition of more specific guidelines for patients with diabetes. Very-high CV risk patients with diabetes are also recommended an LDL-C reduction of ≥50% and an LDL-C goal of <55 mg/dL (<1.4 mmol/L).2

CV risk assessment and treatment targets

All T2DM patients with established ASCVD are considered very-high risk.2

In patients aged ≥40 years with T2DM without ASCVD or severe TOD, it is recommended to estimate 10-year CVD risk using the SCORE2-Diabetes algorithm.

CV risk assessment

LDL-C management algorithm for patients with diabetes2

Level of recommendations:

LDL-C management algorithm

MAT-BE-2500126– v. 1.0 – 01/2025