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cardiology endocrinology

SCORE2-Diabetes 10-Year CVD Risk in Type 2 Diabetes

ESC 2023 model estimating 10-year cardiovascular disease risk in people with type 2 diabetes aged 40 to 69 without established CVD. Extends standard SCORE2 by incorporating HbA1c, diabetes duration, and eGFR. Guides statin intensity and SGLT-2 inhibitor or GLP-1 RA therapy decisions.

Used in: Hypertension Diabetes & DKA

Score interpretation

Low Risk — under 5% 0–5

Estimated 10-year CVD risk under 5% in T2DM

→ Lifestyle optimisation; statin if LDL above 2.5 mmol/L; SGLT-2 inhibitor if CKD or HF coexists; BP target under 130/80 mmHg; individualised HbA1c target; annual CVD risk reassessment

Moderate Risk — 5 to 10% 5–10

Estimated 10-year CVD risk 5 to 10%

→ High-intensity statin (atorvastatin 40 to 80 mg); LDL target under 2.5 mmol/L; SGLT-2 inhibitor (empagliflozin or dapagliflozin) for cardio-renal protection; ACE inhibitor or ARB if hypertension; multifactorial diabetes risk management

High Risk — 10 to 20% 10–20

Estimated 10-year CVD risk 10 to 20%

→ High-intensity statin; LDL target under 1.8 mmol/L; ezetimibe if not at target; SGLT-2 inhibitor mandatory; GLP-1 RA (semaglutide or liraglutide) if BMI above 30 or established HF; BP under 130/80; diabetes and cardiology co-management

Very High Risk — 20% or above 20–100

Estimated 10-year CVD risk 20% or above — very high risk

→ Statin plus ezetimibe; PCSK9 inhibitor if LDL remains above 1.8 mmol/L; LDL target under 1.4 mmol/L; SGLT-2 inhibitor plus GLP-1 RA; aggressive BP and glycaemic control; cardiology referral; annual echo if HF symptoms; aspirin 75 mg if established CVD

Interpretation bands for the SCORE2-Diabetes. Apply clinical judgement and local guidance.

References

Related

Curated clinical cross-links plus same-class fallbacks.

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Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.