In adults with diabetes who do not have advanced artery disease, a drug called evolocumab lowers LDL cholesterol levels from 111 mg/dL to 52 mg/dL after 48 weeks of treatment, even when patients are...

We analyzed the available evidence on evolocumab and LDL cholesterol in people with diabetes but no advanced artery disease, and what we’ve found so far suggests it lowers LDL levels after 48 weeks. One assertion shows that in this group, evolocumab reduced LDL from 111 mg/dL to 52 mg/dL when used alongside the highest tolerated dose of statins [1]. No studies or claims in our review contradicted this finding. Evolocumab is a medication that works by helping the liver remove more LDL cholesterol from the blood. LDL is often called “bad” cholesterol because high levels are linked to increased risk of heart issues, though having diabetes alone doesn’t always mean artery disease is present. The evidence we reviewed focuses on people who already took the strongest statin dose their bodies could handle, yet still had elevated LDL. In that context, adding evolocumab appeared to bring LDL down significantly over one year. We note that this conclusion is based on a single assertion, and while no opposing data was found, the total number of studies analyzed remains very limited. We cannot say whether this drop in LDL translates to fewer heart events, or how long the effect lasts beyond 48 weeks. The evidence we’ve reviewed so far does not include information on side effects, cost, or how this compares to other treatments. For someone with diabetes and high LDL despite statins, this suggests evolocumab may help lower LDL further over the course of a year — but more data is needed to understand the full picture.