54
Management
1
Intensify LDL-C
lowering therapy
2b
Start
moderate-
intensity
statin
2b
Add IPE
LDL-C <100 mg/dL and
elevated triglycerides
≥150–500 mg/dL?
Diabetes-specific risk
enhancers* present?
NO
YES
NO NO YES YES
20–39 y of age
1
Healthy
behavior
counseling
1
Healthy
behavior
counseling
2a
Start
moderate-
intensity
statin
For adults ≥30 y of age,
PREVENT ASCVD 10-y risk
≥3% or 30-y risk ≥10%
Figure 9. Adults With Diabetes and Without ASCVD
apoB indicates apolipoprotein B; ASCVD, atherosclerotic
cardiovascular disease; HDL-C, high-density lipoprotein-
cholesterol; IPE, icosapent ethyl; LDL-C, low-density lipoprotein-
cholesterol; LLT, lipid-lowering therapy; mAb, monoclonal antibody;
and PCSK9, proprotein convertase subtilisin/kexin type 9.
* Refer to Table 17, "Diabetes-Specific Risk Enhancers Independent of Other Diabetes-Related Risk
Factors."
†
In adults with diabetes who have statin-attributed side effects, initiation of ezetimibe and/or
bempedoic acid and/or a PCSK mAb is recommended to lower LDL-C and reduce ASCVD risk.
