Dr Michael Bowen discusses the shift from a glucocentric strategy to a concurrent focus on glucose management and cardiometabolic risk. Diabetes MedTwitter
guidelines recommended a treat-to-target approach to achieve a target low-density lipoprotein cholesterol goal based on coronary heart disease risk category . The 2013 ACC/AHA guideline moved away from cholesterol management based on LDL treatment targets to recommend fixed-dose statin therapy, with dose intensity determined by patient risk. This change, along with lowering the 10-year risk threshold to initiate statins for primary prevention of ASCVD to 7.
Clinicians previously had prescribed statins on the basis of LDL levels and now had to reframe their approach to management of ASCVD risk beyond just the LDL level. This resulted in many patients meeting guideline indications for statins for primary prevention, or having new recommendations for statin intensification, with what previously were considered LDL levels"at goal.
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