Because primary-prevention trials demonstrate that moderate-intensity statin therapy in large cohorts with diabetes mellitus provides significant this treatment is indicated in such individuals. However, given the increased morbidity and mortality associated with a first event in diabetes mellitus and the residual risk among the statin-treated groups in these trials, together with the evidence of benefit from high-intensity statin treatment in primary prevention among men >50 years of age and women high-intensity statin therapy to maximize risk reduction is preferred for patients with diabetes mellitus as they age or if they have risk modi- fiers. Adults 20 to 39 years of age are mostly at low 10-year risk, although moderate-intensity statin thera- py in those with long-standing diabetes mellitus or a concomitant higher-risk condition may be reasonable Adults >75 years of age with Recommendations for Patients With Diabetes Mellitus (Continued) COR LOE Recommendations CLINICAL STATEMENTS AND GUIDELINES diabetes mellitus are at high-riskS4.3-5,S4.3-8 and clinical suggests they are likely to benefit from continuing or initiating statin therapy, although this may be compromised by reduced longevity and in- creased adverse events. Recommendation-Specific Supportive Text 1. Most adults 40 to 75 years of age with diabetes mellitus are at intermediate or high-risk (PCE 7.5% 10-year risk) of ASCVD events.S4.3-5,S4.3-6,S4.3-8,S4.3-9 Three of 4 double-blinded primary-preven- tion RCTs of moderate statin therapy in large cohorts with diabetes mellitus in this age range showed significant reductions in ASCVD A meta-analysis of these trials found that moderate-intensity statin therapy is associated with a risk reduction of 25%,S4.3-3 resulting in a risk level similar to that of people without diabetes mellitus and with no apparent difference in benefit between type 1 and type 2 diabetes mellitus. 