How do I install the Endo Ldl Goal Less Than 70 T2d skill?

Run npx skillmds@latest add dromlakhani/endo-ldl-goal-less-than-70-t2d in your terminal (requires Node.js), paste this page's agent-chat prompt into Claude, Cursor, or any MCP-connected agent, or download the SKILL.md file and copy it into your agent's skills directory.

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Who published Endo Ldl Goal Less Than 70 T2d?

dromlakhani (@dromlakhani) published this skill. Their other Agent Skills are listed on their SkillMD profile.

Endo Ldl Goal Less Than 70 T2d by dromlakhani

Name: Endo Ldl Goal Less Than 70 T2d
Rating: 4.2 (5 reviews)
Author: dromlakhani

Endo Ldl Goal Less Than 70 T2d

Recommends lowering LDL-C to <70 mg/dL in adults with type 2 diabetes and cardiovascular risk factors to reduce ASCVD risk. Consider when encountering a patient with T2D and CV risk factors, LDL-C >70 mg/dL requiring treatment, or when assessing lipid-lowering therapy goals in diabetes.

dromlakhani Updated Sep 8, 2026 10 repo stars

File contents

LDL-C goal less than 70 mg/dL for type 2 diabetes

STEP 1 — Gather Information

Collect: type 2 diabetes diagnosis, cardiovascular risk factors (traditional: age ≥40, hypertension, smoking, family history of premature ASCVD; risk-enhancing: elevated Lp(a) ≥50 mg/dL, CKD, metabolic syndrome, albuminuria), current LDL-C level, current lipid-lowering therapy, lifestyle modifications, renal function, pregnancy status. Action: Proceed to assess whether the patient has T2D and cardiovascular risk factors.

STEP 2 — Rule In / Rule Out

Does the patient have type 2 diabetes mellitus and at least one cardiovascular risk factor? If yes, proceed to evaluate LDL-C goal; if no, the LDL-C <70 mg/dL goal does not apply (consider alternative lipid management per other guidelines). Action: If yes, go to Step 3; if no, stop here and follow general lipid management.

STEP 3 — Classify or Stratify

Classify cardiovascular risk: high risk if established ASCVD or multiple risk factors (≥2 traditional risk factors or risk-enhancing factors); moderate risk if T2D with risk factors but no established ASCVD and fewer than multiple risk factors. Action: For high risk, consider LDL-C goal <55 mg/dL; for moderate risk, LDL-C goal <70 mg/dL.

STEP 4 — Decide

If LDL-C is above the applicable goal (<70 mg/dL for moderate, <55 mg/dL for high risk), initiate lifestyle modification plus statin therapy; if LDL-C remains above goal despite maximally tolerated statin, add ezetimibe or PCSK9 inhibitor; if triglycerides 150–499 mg/dL with residual hypertriglyceridemia on statin, consider adding 4 g/day EPA ethyl ester. Action: Implement lipid-lowering regimen per classification.

Clinical Guardrails / Mimics / Pitfalls

Do not initiate statin therapy in pregnancy or if planning pregnancy; select statin based on renal clearance (pitavastatin, pravastatin, rosuvastatin preferred in CKD); monitor for myopathy, especially with drugs interacting via CYP3A4; do not rely on LDL-C alone when triglycerides >500 mg/dL (use non-HDL-C or apoB); avoid fibrates if triglycerides >500 mg/dL; do not use niacin due to limited benefit and safety concerns.

Concrete Clinical Example

A 58-year-old man with type 2 diabetes, hypertension, and LDL-C 110 mg/dL has no prior ASCVD. He has moderate risk; goal LDL-C <70 mg/dL. Lifestyle changes and moderate-intensity statin (atorvastatin 20 mg) are started; LDL-C drops to 68 mg/dL, meeting goal.

Source: Lipid Management in Patients with Endocrine Disorders: An Endocrine Society Clinical Practice Guideline, Endocrine Society, 2020, DOI:10.1210/clinem/dgaa674

TODO: consider adding scripts/calc.py for the endo-ldl-goal-less-than-70-t2d calculator

---name: endo-ldl-goal-less-than-70-t2ddescription: Recommends lowering LDL-C to <70 mg/dL in adults with type 2 diabetes and cardiovascular risk factors to reduce ASCVD risk. Consider when encountering a patient with T2D and CV risk factors, LDL-C >70 mg/dL requiring treatment, or when assessing lipid-lowering therapy goals in diabetes.---# LDL-C goal less than 70 mg/dL for type 2 diabetes## STEP 1 — Gather InformationCollect: type 2 diabetes diagnosis, cardiovascular risk factors (traditional: age ≥40, hypertension, smoking, family history of premature ASCVD; risk-enhancing: elevated Lp(a) ≥50 mg/dL, CKD, metabolic syndrome, albuminuria), current LDL-C level, current lipid-lowering therapy, lifestyle modifications, renal function, pregnancy status. Action: Proceed to assess whether the patient has T2D and cardiovascular risk factors.## STEP 2 — Rule In / Rule OutDoes the patient have type 2 diabetes mellitus and at least one cardiovascular risk factor? If yes, proceed to evaluate LDL-C goal; if no, the LDL-C <70 mg/dL goal does not apply (consider alternative lipid management per other guidelines). Action: If yes, go to Step 3; if no, stop here and follow general lipid management.## STEP 3 — Classify or StratifyClassify cardiovascular risk: high risk if established ASCVD or multiple risk factors (≥2 traditional risk factors or risk-enhancing factors); moderate risk if T2D with risk factors but no established ASCVD and fewer than multiple risk factors. Action: For high risk, consider LDL-C goal <55 mg/dL; for moderate risk, LDL-C goal <70 mg/dL.## STEP 4 — DecideIf LDL-C is above the applicable goal (<70 mg/dL for moderate, <55 mg/dL for high risk), initiate lifestyle modification plus statin therapy; if LDL-C remains above goal despite maximally tolerated statin, add ezetimibe or PCSK9 inhibitor; if triglycerides 150–499 mg/dL with residual hypertriglyceridemia on statin, consider adding 4 g/day EPA ethyl ester. Action: Implement lipid-lowering regimen per classification.## Clinical Guardrails / Mimics / PitfallsDo not initiate statin therapy in pregnancy or if planning pregnancy; select statin based on renal clearance (pitavastatin, pravastatin, rosuvastatin preferred in CKD); monitor for myopathy, especially with drugs interacting via CYP3A4; do not rely on LDL-C alone when triglycerides >500 mg/dL (use non-HDL-C or apoB); avoid fibrates if triglycerides >500 mg/dL; do not use niacin due to limited benefit and safety concerns.## Concrete Clinical ExampleA 58-year-old man with type 2 diabetes, hypertension, and LDL-C 110 mg/dL has no prior ASCVD. He has moderate risk; goal LDL-C <70 mg/dL. Lifestyle changes and moderate-intensity statin (atorvastatin 20 mg) are started; LDL-C drops to 68 mg/dL, meeting goal.**Source:** Lipid Management in Patients with Endocrine Disorders: An Endocrine Society Clinical Practice Guideline, Endocrine Society, 2020, DOI:10.1210/clinem/dgaa674> **TODO:** consider adding scripts/calc.py for the endo-ldl-goal-less-than-70-t2d calculator

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