Changes in Statin Use Among U.S. Adults With Diabetes: A Population-Based Analysis of NHANES 2011–2018

Abstract

OBJECTIVE To evaluate statin use in the U.S. before and after the 2015 American Diabetes Association position statement, which expanded statin therapy recommendations to include all adults 40–75 years old with diabetes. RESEARCH DESIGN AND METHODS The National Health and Nutrition Examination Survey (NHANES) was used to obtain a representative sample. The difference-in-differences technique determined the impact of the recommendation on the proportion of people with diabetes for whom statin therapy was newly recommended. RESULTS Among people with diabetes, the change in statin use in people without atherosclerotic cardiovascular disease (ASCVD) risk factors, controlling for change among people with ASCVD/risk factors, was 6.6% (P = 0.388). In the adjusted analysis, overt ASCVD, age, Black race, health insurance, a place for routine care, and total cholesterol were significantly associated with statin use (P < 0.05). CONCLUSIONS The most recent change in statin recommendations had minimal impact on the proportion of patients receiving a statin.