本篇文章主要是根據美國糖尿病學會（ADA）發布的「標準化糖尿病照護，2018 年」的第九章糖尿病的心血管疾病和危險因素的處理照護章節部分，討論如何照護糖尿病合併血脂異常的患者。本次標準治療建議指引對糖尿病合併血脂異常的患者依照兩大類別進行風險分層修改：那些具有ASCVD 記錄的和沒有ASCVD 記錄的。由於研究表明老年人與中年人的益處相似，因此對於40-75 歲的糖尿病患者和> 75 歲無ASCVD 的患者綜合建議使用中等強度statin 類藥物治療。表一(“statin 類藥物和成人糖尿病聯合治療的建議”) 根據新的風險分層方法和合併年齡組進行了更新。為了適應新類別的降血脂藥物的最新研究數據結果，修改了一項建議，就是可以加上non-statin 類藥物降低LDL 療法，以用來為那些具有糖尿病和ASCVD 但LDL 膽固醇仍然≥ 70mg/dL 的患者提供額外的指引，儘管他們的statin 類藥物已經使用到最大可耐受劑量。

This article focuses on how to care for patients with diabetes mellitus complicated with dyslipidemia, based on the Nineth chapter of the American Diabetes Association (ADA), “ Cardiovascular Disease and Risk Management: Standards of Medical Care in Diabetes-2018.” The lipid management recommendations were modified to stratify risk based on two broad categories: those with documented ASCVD and those without. Owing to studies suggesting similar benefits in older versus middle-aged adults, recommendations were consolidated for patients with diabetes 40-75 years and > 75 years of age without ASCVD to use moderate-intensity statin. Table 1 (“Recommendations for statin and combination treatment in adults with diabetes”) was updated based on the new risk stratification approach and consolidated age-groups. To accommodate recent data on new classes of lipid-lowering medications, a recommendation was modified to provide additional guidance on adding nonstatin LDL-lowering therapies for patients with diabetes and ASCVD who have LDL cholesterol ≥ 70 mg/dL despite maximally tolerated statin dose.