This Article Full Text Full Text (PDF) All Versions of this Article: 0145721708328597v1 35/3/408    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Robinson, M. T. Search for Related Content PubMed PubMed Citation Articles by Robinson, M. T. Pubmed/NCBI databases Substance via MeSH Medline Plus Health Information Diabetes Type 1 Social Bookmarking                         What's this?

Nutrition Evidence-Based Guidelines for Treating Hyperlipidemia in Children With Type 1 Diabetes

A Case Presentation

From The Children's Hospital of Philadelphia, The Diabetes Center for Children, Philadelphia, Pennsylvania.

Correspondence to Megan Thomas Robinson, MS, RD, CDE, LDN, The Children's Hospital of Philadelphia, The Diabetes Center for Children, 34th Street and Civic Center Boulevard, 8th Floor Main Building–Endocrinology, Philadelphia, PA 19104 (robinsonme{at}email.chop.edu).

Purpose

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 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.

This version was published on May 1, 2009

The Diabetes Educator, Vol. 35, No. 3, 408-419 (2009)
DOI: 10.1177/0145721708328597


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?