Glucose control predicts 2-year change in lipid profile in youth with type 1 diabetes.
OBJECTIVE
To test the hypothesis that a change in glycated hemoglobin (A1c) over a follow-up interval of approximately 2 years would be associated with concomitant changes in fasting lipids in individuals with type 1 diabetes (T1D).


METHODS
All subjects with T1D diagnosed in 2002-2005 in the SEARCH for Diabetes in Youth study with at least 2 study visits ∼12 and ∼24 months after an initial visit were included (age at initial visit, 10.6 ± 4.1 years; 48% female; diabetes duration, 10 ± 7 months; 76% non-Hispanic white; A1c = 7.7% ± 1.4%). Longitudinal mixed models were fit to examine the relationship between change in A1c and change in lipid levels (total cholesterol [TC], high-density lipoprotein-cholesterol [HDL-c], low-density lipoprotein-cholesterol [LDL-c], log triglycerides [TG], and non-HDL-c) with adjustment for possible confounders.


RESULTS
Change in A1c over time was significantly associated with changes in TC, HDL-c, LDL-c, TG, and non-HDL-c over the range of A1c values. For example, for a person with an A1c of 10% and then a 2% decrease in A1c 2 years later (to 8%), the model predicted concomitant changes in TC (-0.29 mmol/L, -11.4 mg/dL), HDL-c (0.03 mmol/L, 1.3 mg/dL), LDL-c (-0.23 mmol/L, -9.0 mg/dL), and non-HDL-c (-0.32 mmol/L, -12.4 mg/dL) and an 8.5% decrease in TG (mmol/L).


CONCLUSIONS
Improved glucose control over a 2-year follow-up was associated with a more favorable lipid profile but may be insufficient to normalize lipids in dyslipidemic T1D youth needing to decrease lipids to goal.
Barbara Davis Center for Childhood Diabetes, University of Colorado Denver, Aurora, CO, USA. David.Maahs@ucdenver.edu
David M
DM
Maahs
Dana
D
Dabelea
Ralph B
RB
D'Agostino
Jeannette S
JS
Andrews
Amy S
AS
Shah
Nancy
N
Crimmins
Elizabeth J
EJ
Mayer-Davis
Santica
S
Marcovina
Giuseppina
G
Imperatore
R Paul
RP
Wadwa
Steven R
SR
Daniels
Kristi
K
Reynolds
Richard F
RF
Hamman
Lawrence M
LM
Dolan
D001786:Blood Glucose / Q000032:analysis; D002648:Child; D002784:Cholesterol / Q000097:blood*; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000628:therapy*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis*; D006801:Humans; D008297:Male; D011379:Prognosis; D013997:Time Factors; D014280:Triglycerides / Q000097:blood*
D001786:Blood Glucose; D002784:Cholesterol; D006442:Glycated Hemoglobin; D014280:Triglycerides