Quality statement 3: Statin therapy for primary prevention of cardiovascular disease
Statin therapy for adults with type 1 diabetes aged 40 and over aims to reduce cardiovascular risk and prevent future cardiovascular events. It helps to lower the concentration of low-density lipoprotein cholesterol in the blood and is associated with a reduction in myocardial infarction, coronary heart disease and stroke.
The following measures can be used to assess the quality of care or service provision specified in the statement. They are examples of how the statement can be measured, and can be adapted and used flexibly.
Proportion of adults with type 1 diabetes aged 40 and over who are prescribed statins for the primary prevention of CVD.
Numerator – the number in the denominator who are prescribed statins for the primary prevention of CVD.
Denominator – the number of adults with type 1 diabetes aged 40 and over.
Data source: NHS Digital's Quality and Outcomes Framework indicator DM022 collects data on patients with diabetes aged 40 years and over, with no history of CVD and without moderate or severe frailty, who are currently treated with a statin (excluding people with type 2 diabetes and a CVD risk score of less than 10% recorded in the preceding 3 years). The National Diabetes Audit collects national data on the number of adults with type 1 diabetes aged 40 to 80 having statins for primary prevention of CVD.
Service providers (GP practices and secondary care providers) ensure that systems are in place for adults with type 1 diabetes aged 40 and over to be identified and offered statins for the primary prevention of CVD.
Healthcare professionals (such as GPs, advanced nurse practitioners in primary care, consultant diabetologists and diabetes specialist nurses) identify adults with type 1 diabetes aged 40 and over and offer them statins for the primary prevention of CVD, explaining the benefits to them.
Integrated care systems ensure that services are available to provide statins for the primary prevention of CVD to adults with type 1 diabetes aged 40 and over.
Adults with type 1 diabetes aged 40 and over are offered statins to help prevent them having a heart attack, heart disease or a stroke.
Cardiovascular disease: risk assessment and reduction, including lipid modification. NICE guideline NG238 (2023), recommendation 1.6.10
The prescription of statins for people with diabetes with no history of heart disease to reduce the risk of CVD.
Adults with type 1 diabetes can be started on atorvastatin 20 mg. [NICE's guideline on cardiovascular disease: risk assessment and reduction, including lipid modification, recommendation 1.6.12, and the National Diabetes Audit]
Statins are contraindicated in women able to have children and not using reliable contraception, pregnant women and women who are breastfeeding. They should be stopped 3 months before trying to conceive. Healthcare professionals should ensure that they take this into account when considering whether to offer statins and explain this to women who are offered statins.