It is estimated that at least 170 million people around the world have diabetes mellitus and this number will probably more than double by 2030. The rapid rise in prevalence is mainly attributable to a rising incidence of type 2 diabetes. However, both types are associated with a greatly increased risk of vascular disease, so identifying treatment and prevention methods are a major public health priority.
The main mechanism behind the increase in vasclur disease in diabetes is the association of both types of diabetes with dyslipidaemia. We do know that statin therapy reduces the risk of vascular disease in diabetics, but we don't know whether these effects depend on the type of diabetes, the particular lipid profile or other factors.
This study, undertaken by the Cholesterol Treatment Trialis's Collaboration, analysed information from more than 18 000 individuals with diabetes, mainly type 2 diabetes, comparing them with more than 71 000 people without diabetes in 14 randomised trials of statin therapy. The effects of statins was measured by looking at the reduction in vascular events per 1.0 mmol/l reduction in LDL cholesterol. Over just over four years, there were 3247 major vascular events in the diabetics. There was also a 9% reduction in deaths from any cause per mmol/l reduction in LDL cholesterol, compared with a 13% reduction in those without diabetes. This showed that statins had a significant effect on deaths from vascular disease and no effect on deaths that were not caused by vascular disease. This was shown as reduction in the incidence of heart attacks, strokes and death from other coronary causes. Among the diabetics, the effects of statin therapy were similar regardless of whether or not the individuals already had vascular disease.
The fundamental finding was that after five years, diabetics who were taking statins had fewer major vascular events overall. This lead to the conclusion that statin therapy should be considered for all diabetics who are thought to be at risk of vascular disease.
