Nutrition evidence-based guidelines for treating hyperlipidemia in children with type 1 diabetes: a case presentation.
OBJECTIVE
The purpose of this case presentation is to review the current nutrition evidence-based guidelines and treatment goals for hyperlipidemia in children with type 1 diabetes. The American Heart Association (AHA) places children with type 1 diabetes in the highest tier for cardiovascular risk.


METHODS
Early screening for hyperlipidemia in children with diabetes is recommended to identify those children at risk. If the fasting low-density lipoprotein cholesterol (LDL-C) level is > or = 100 mg/dL (2.6 mmol/L), medical nutrition therapy is recommended as the first line of treatment to reach the desired goal (LDL-C <100 mg/dL). Medical nutrition therapy includes the following: decreasing saturated fat (<7% total calories), avoiding trans fatty acids, decreasing total cholesterol to <200 mg daily, increasing soluble fiber, and adding phytosterols daily.


RESULTS
The patient discussed in this case presentation achieved a desired LDL-C level <100 mg/dL (2.6 mmol/L) by following the recommended heart-healthy guidelines. Statin therapy was not considered unless the LDL-C goal, <130 mg/dL (3.38 mmol/L), was not achieved by diet alone.


CONCLUSIONS
In this case study, evidence-based nutrition guidelines have been evaluated and reviewed to demonstrate heart-healthy eating for children with hyperlipidemia and type 1 diabetes. It is known that approximately 40% to 50% of children with elevated lipids will continue to have abnormal lipids into adolescence and early adulthood. Therefore, early screening is recommended by the AHA to track lipid changes during childhood and adolescence and to begin treating abnormal LDL-C levels to prevent the development of atherosclerosis.
The Children's Hospital of Philadelphia, The Diabetes Center for Children, 8th Floor Main Building-Endocrinology, Philadelphia, PA 19104, USA. robinsonme@email.chop.edu
Megan Thomas
MT
Robinson
D002648:Child; D008078:Cholesterol, LDL / Q000097:blood / Q000187:drug effects; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000150:complications* / Q000188:drug therapy / Q000534:rehabilitation*; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D006949:Hyperlipidemias / Q000150:complications* / Q000175:diagnosis / Q000534:rehabilitation*; D007332:Insulin Infusion Systems; D007858:Learning; D008403:Mass Screening; D015596:Nutrition Assessment; D010353:Patient Education as Topic; D010840:Phytosterols / Q000627:therapeutic use; D017410:Practice Guidelines as Topic
D008078:Cholesterol, LDL; D010840:Phytosterols