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. Therefore, on the basis of a high level of evidence, moderate-intensity statin therapy is indicated in patients 40 to 75 years of age with diabetes mellitus for primary prevention. 2. Although it is well recognized that the frequency of a first ASCVD event in adults with diabetes mellitus is significantly increased compared with those without diabetes mellitus, there is a wide spectrum of risk among individuals with diabe- that varies with age, duration of diabetes mellitus, and the presence of traditional risk factors and risk modifiers com- mon to the general population, as well as those specific to the population with diabetes mellitus (Table 5). Because the decision to upgrade statin treatment from moderate to high intensity is influenced by the level of ASCVD risk, the PCE risk estimator in adults 40 to 75 years of age with diabetes mellitus has utility in refining treatment decisions in these patients.S4.3-10,S4.3-11 The ASCVD risk score, however, does not determine whether statin intensity should be increased. 