Background: Cardiovascular disease (CVD) is the major cause of mortality in diabetes mellitus type 1 (T1DM). Dyslipidemia will increase this risk. Several guidelines have been published, how to treat dyslipidemia in T1DM, yet some studies have shown that the number of patients who are treated according to these guidelines is low.
Objective and hypotheses: To investigate the frequency of dyslipidemia in children and adolescents with T1DM and if they are treated according to recent guidelines and if not, to identify the reason why guidelines were not followed.
Method: All children and adolescents with T1DM from the pediatric and transition diabetes outpatient clinic of the University Medical Center Groningen were retrospectively investigated. 210 persons with T1DM (112 male and 98 female), 324 years old were included. Data of lipid profiles, HbA1c, smoking and BMI and in patients with dyslipidemia (LDL-c≧2.6 mmol/l), tracking of LDL-c (defined as ≧75% of the LDL-c results ≧ 2.6 mmol/l), blood pressure, family history for dyslipidemia and CVD, were collected. We investigated if patients were treated according to the guidelines and asked the treating physician for possible reasons to deviate from it.
Results: 41.9% (n=88) of the patients had dyslipidemia. Dyslipidemia was significantly associated with age, female sex, HbA1c and BMI. In patients with dyslipidemia 65.6% showed tracking of LDL cholesterol, 42.5% had a positive family history for CVD and 28.8% for dyslipidemia. 11.4% of the patients with dyslipidemia were treated with a diet and 5.7% with statins. The most important reasons for not treating dyslipidemia were mild increase of LDL cholesterol (46.6%) and bad compliance with high HbA1c (28.4%).
Conclusion: Dyslipidemia is frequently seen in patients with T1DM, yet treatment percentage is low. Awareness for early intervention is important. Research to investigate the benefit of treatment is needed.
01 - 03 Oct 2015
European Society for Paediatric Endocrinology