ESPE2014 Poster Presentations Diabetes (2) (11 abstracts)
Algorithm-Based Cholesterol Monitoring in Children with Type 1 Diabetes
K Otfried Schwab a , Juergen Doerfer b , Christa Scheidt-Nave c , Bärbel-Maria Kurth d , Andreas Hungele e , Nicole Scheuing f , Andreas Krebs g , Axel Dost h , Tilman R Rohrer i , Edith Schober j & Reinhard W Holl k
aUniversity Hospital, Freiburg, Baden-Württemberg, Germany; bUniversity Hospital, Freiburg, Baden-Württemberg, Germany; cRobert-Koch-Institute, Berlin, Germany; dRobert-Koch-Institute, Berlin, Germany; eUniversity Ulm, Ulm, Baden-Württemberg, Germany; fUniversity Ulm, Ulm, Baden-Württemberg, Germany; gUniversity Hospital, Freiburg, Baden-Württemberg, Germany; hUniversity Hospital, Jena, Thuringia, Germany; iSaarland University, Homburg, Saarland, Germany; jUniversity Hospital, Vienna, Austria; kUniversity Ulm, Ulm, Baden-Württemberg, Germany
Background: Lipid profiles of type 1 diabetic children are influenced by age, sex, BMI- and HbA1c-values. There is a discrepancy between increased cholesterol levels and the management required. Thus, 26% of patients have dyslipidemia but only 0.4% of them receive lipid lowering medication.
Objective and hypothesis: To facilitate child-specific and diabetes-related cholesterol control, we developed a monitoring algorithm derived from population-based reference values.
Method: LDL-, non-HDL-, and HDL cholesterol percentile values were calculated for children with type 1 diabetes and non-diabetic peers within algorithm-based categories of sex, age: 1–10 vs >10–<18 years, BMI: <90th vs ≥90th percentile, and HbA1c <6%, 6–<7.5%, 7.5–9%, >9%. Analyses included 26 147 patients sampled from a German/Austrian population-based registry for type 1 diabetes (DPV) and 14 057 non-diabetic peers participating in the national health interview and examination survey for children and adolescents (KiGGS) in Germany.
Results: HDL-C values are almost higher in diabetic children than healthy peers. Very good controlled children with diabetes (HbA1c <7.5%) have a less atherogenic lipid profile compared to healthy peers. However, pubertal, overweight diabetic girls with a poor diabetes control show the most atherogenic lipid profile. HbA1c values influence the lipid profile most markedly, less in prepubertal than in pubertal children.
Conclusion: The population-based algorithmic approach applied to LDL-, non-HDL-, and HDL cholesterol allows referencing diabetic children with regard to their non-diabetic peers and, if necessary, suggesting corrections of glycemic control to optimize long-term cholesterol monitoring. Pubertal overweight girls with a poor diabetes control need the most careful monitoring.
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