VentralinkUnderstanding Statins Series: This article covers why statins are critical for people with diabetes. New to statins? Start with Article 1: Why Statins Matter.
Key Takeaway — Click to expand
If you have diabetes, statins are one of the most effective ways to protect your heart. Clinical trials show they reduce heart attacks, strokes, and cardiovascular deaths by 20-40% in people with diabetes. Guidelines now recommend statins for nearly all adults with diabetes aged 40-75.
If you have diabetes, your doctor has probably talked to you about statins—or already prescribed one. There's a good reason for that. Diabetes significantly raises your risk of heart disease, and statins are one of the most proven ways to bring that risk back down.
This article explains why statins matter so much for people with diabetes, what the research shows, and what current guidelines recommend.
Why Diabetes Raises Heart Risk
Having type 2 diabetes roughly doubles or triples your risk of heart attack and stroke. High blood sugar damages arteries over time, speeding up the buildup of plaque that leads to blocked vessels. This process happens even when blood sugar is well controlled with medications.
🫀 The Heart-Diabetes Connection
Heart disease is the leading cause of death in people with diabetes. About two-thirds of people with diabetes will eventually die from heart disease or stroke. This is why protecting your heart is just as important as controlling your blood sugar.
The good news: because people with diabetes face elevated heart risk, they also benefit more from treatments that lower that risk. Statins are at the top of that list.
What the Research Shows
Two landmark trials proved beyond doubt that statins dramatically reduce cardiovascular events in people with diabetes.
Collaborative Atorvastatin Diabetes Study
The first large trial designed specifically for people with type 2 diabetes who had never had a heart attack or stroke. All participants had at least one other risk factor like high blood pressure or smoking.
2,838 patients with type 2 diabetes • Atorvastatin 10mg vs placebo
Placebo
127
major CV events
Atorvastatin
83
major CV events
37% fewer heart attacks, strokes, and cardiac deaths
48% fewer strokes
The trial was stopped nearly two years early because the benefit was so clear it would have been unethical to continue giving placebo.
5,963 people with diabetes within a larger 20,536-patient trial
This trial included people with and without prior heart disease, showing statin benefit across the full range of diabetic patients.
Placebo
748
major vascular events
Simvastatin
601
major vascular events
22% reduction overall • 33% reduction in those without prior heart disease
The benefit was the same whether starting cholesterol was "high" or "normal"—challenging the idea that you only need a statin if your cholesterol is elevated.
Later studies pooling data from nearly 19,000 diabetic patients across 14 trials confirmed these findings: statins reduce major cardiovascular events by about 20% for every 39 mg/dL drop in LDL cholesterol.
What Guidelines Now Recommend
Based on this evidence, medical guidelines recommend statins for nearly all adults with diabetes. The American Diabetes Association's 2025 Standards of Care outline a tiered approach:
ADA 2025 Statin Recommendations
All Adults with Diabetes (Ages 40-75)
At minimum, moderate-intensity statin therapy along with lifestyle changes.
Diabetes + Additional Risk Factors
High-intensity statin therapy aiming to reduce LDL by 50% or more, with a goal below 70 mg/dL. Risk factors include: older age, high blood pressure, smoking, obesity, family history of heart disease.
Diabetes + Established Heart Disease
High-intensity statin with LDL goal below 55 mg/dL. May need additional cholesterol-lowering medications like ezetimibe or PCSK9 inhibitors.
The Bottom Line
If you have diabetes, a statin isn't just about cholesterol—it's about protecting your heart and blood vessels from the accelerated damage that diabetes causes. The evidence is clear: statins reduce heart attacks, strokes, and deaths by 20-40% in people with diabetes. For most adults with diabetes, the question isn't whether to take a statin, but which intensity is right for your risk level.