Statins significantly reduce mortality risk for adults with diabetes, regardless of cardiovascular risk

Embargoed for release until 5:00 p.m. ET on Monday 29 December 2025   

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Below please find summaries of new articles that will be published in the next issue of Annals of Internal Medicine. The summaries are not intended to substitute for the full articles as a source of information. This information is under strict embargo and by taking it into possession, media representatives are committing to the terms of the embargo not only on their own behalf, but also on behalf of the organization they represent.   
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1. Statins significantly reduce mortality risk for adults with diabetes, regardless of cardiovascular risk

Abstract: https://www.acpjournals.org/doi/10.7326/ANNALS-25-00662

URL goes live when the embargo lifts             

A large cohort study found that statins significantly reduce the risk of death and major cardiovascular events in adults with type 2 diabetes, even among those with low predicted 10-year cardiovascular risk. The findings challenge long-standing uncertainty about whether patients at the lowest risk benefit from preventive statin therapy, suggesting that the drugs may have broader protective value than previously assumed. The findings are published in Annals of Internal Medicine.

Researchers from the University of Hong Kong and colleagues analyzed data from the IQVIA Medical Research Data (IMRD)-UK database to evaluate the effectiveness and safety of statin initiation for primary prevention among adults with type 2 diabetes stratified by predicted 10-year risk of cardiovascular disease. The study population included people in the UK with type 2 diabetes aged 25 to 84 who were followed for up to 10 years. None of these patients had serious heart or liver problems before the study began. The researchers compared people who initiated statin use with those who did not across different levels of predicted heart disease risk. The data showed that statins lowered the chances of dying from any cause and reduced the risk of major cardiac events for all patients, even those considered at low risk. The authors noted a very small increase in myopathy was seen in one risk group, but there was no added risk of liver issues. According to the researchers, these data suggest that clinicians should consider the benefits of using statins in all adults with type 2 diabetes even when short-term predicted cardiovascular disease risk is low.

Media contacts: For an embargoed PDF, please contact Gabby Macrina at gmacrina@acponline.org. To contact corresponding author Eric Y.F. Wan please email yfwan@hku.hk. 

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2. Updated VA/DoD guidelines for CKD highlight SGLT2 inhibitors, GLP-1 RAs, and statins for risk reduction

Abstract: https://www.acpjournals.org/doi/10.7326/ANNALS-25-03499

URL goes live when the embargo lifts             

The U.S. Department of Veterans Affairs (VA) and U.S. Department of Defense (DoD) updated their 2019 clinical practice guideline (CPG) for the management of chronic kidney disease (CKD), emphasizing early detection, risk stratification, and expanded pharmacologic options. Of the 23 recommendations included, 21 are new or updated from the 2019 CPG, including treatment with a sodium–glucose cotransporter 2 inhibitor (SGLT2i) or a glucagon-like peptide 1 receptor agonist (GLP-1 RA) in patients with type 2 diabetes and albuminuria. A summary of recommendations most relevant for primary care physicians is published in Annals of Internal Medicine.  

To inform the 2025 updated CPG, the VA and DoD compiled a multidisciplinary work group with expertise in nephrology, internal medicine, and other specialties. The work group used a systematic review of peer-reviewed literature published from 14 September 2018 to 30 June 2024 to develop recommendations. Key recommendations include the use both estimated glomerular filtration rate (eGFR) and urine albumin-to-creatinine ratio (UACR) for diagnosis and risk prediction; the use of a validated kidney failure risk prediction model for management of patients with G3 to G5 CKD; shared decision-making for kidney replacement therapy; and an interdisciplinary care team and early referral to nephrology for patients with progressive CKD. 11 recommendations concerned pharmacological management, including strong recommendations for use of statins in patients with CKD not on dialysis; use of either an angiotensin-converting enzyme inhibitor (ACE-I) or an angiotensin II receptor blocker (ARB) in patients with hypertension and albuminuria; and referral of patients with autosomal-dominant polycystic kidney disease (ADPKD) to nephrology to consider tolvaptan.

Media contacts: For an embargoed PDF, please contact Gabby Macrina at gmacrina@acponline.org. To contact corresponding author James Sall, PhD please email James.Sall@va.gov. 

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Also new this issue:

Management of Conflicts of Interest in Practice Guidelines: Time to Also Account for Open-Mindedness?

Elie A. Akl, MD, MPH, PhD; Zachary Munn, BMedRad, GradDip HlthSc, MPH, PhD; and Joanne Khabsa, BS Pharm, MPH

Ideas and Opinions

Abstract: https://www.acpjournals.org/doi/10.7326/ANNALS-25-02802

The Pharmaceutical Industry’s Quiet Win in the One Big Beautiful Bill Act

Shria Bucha, BA; Matthew J. Martin, MA; and William B. Feldman, MD, DPhil, MPH

Ideas and Opinions

Abstract: https://www.acpjournals.org/doi/10.7326/ANNALS-25-03558