According to recommendations from the Canadian Diabetes Association, all patients with diabetes should begin taking statins at age 40 and blood pressure drugs at 55. These recommendations hold even for those patients who have no other risk factors. And, if a patient over 30 has had diabetes for 15 years or more, the Canadian experts recommend that he or she too should begin taking statins.
Although these recommendations may seem to deviate from those put forth by the American Diabetes Association, when looking more closely, they are not so different, says Dr. Sue Kirkman of the University of North Carolina at Chapel Hill and former chair of medical affairs for ADA. ADA recommends statins for those age 40 and over who have one other risk factor, and most individuals with diabetes have hypertension at that age as well. In terms of blood pressure drugs, ADA recommends blood pressure drugs for those diabetics with hypertension, microalbuminuria (protein in the urine, a harbinger of kidney disease), or cardiovascular disease, which would cover the majority of individuals 55 and over.
And Dr. Alice Cheng of St. Michael s Hospital in Toronto makes a point that these recommendations are based on Grade D, consensus-level evidence, meaning that the recommendations are based on expert opinion but research on the subject has not been systematically reviewed. She also adds that There will always be those who choose to err on the side of undertreating and avoiding overtreatment, but at the other end of the spectrum you have those who prefer to overtreat some [patients] and not miss any. [The recommendation] is somewhere in the middle, and makes the most sense.
