Glycemic control and dyslipidemia in children and adolescents with type 1 diabetes

Abstract

Introduction. Dyslipidemias are complex qualitative or quantitative alterations of lipid metabolism. Their prevalence in children and adolescents with type 1 diabetes reaches up to 39%, depending on the glycemic control. Aim of the study. To evaluate glycemic control in children and adolescents of different ages and its correlation to dyslipidemia. Materials and methods. The retrospective study included 203 patients aged between 1 and 17, treated in “Institutul Mamei si Copilului” hospital during January - July 2019. Data collected: age, sex, duration of Diabetes mellitus type 1 (DM1), glycated haemoglobin (HbA1c), basal blood glucose, postprandial blood glucose, total cholesterol, β- lipoproteins, triglycerides (TG). Results. Patients were classified into 4 groups, according to age: younger than 7 years old: 38 patients, between 8 and11: 65 patients, between 12 and15: 64 patients, older than 15: 36 patients. The oldest children had the worst control of diabetes: the average value of HbA1c was 10,0 ± 1,9 % in group of children older than 15 and 9,5 ± 1,8% in children between 12 and 15 years old. We compared basal and postprandial glycemia from hospitalization to discharge in each age group and found that the best results were obtained in children between 8 and11 years old, where basal blood glucose decreased by 3,8 mmol/l on average (p<0,01) and postprandial blood glucose decreased by 3,9 mmol/l on average (p<0,05). Even though patients aged 12 to 15had poor diabetes control, they also obtained good results after treatment: blood glucose decreased by 3,0 mmol/l (p<0,05) and postprandial blood glucose decreased by 2,9 mmol/l (p<0,05). In the other groups, the changes were less significant. Dyslipidemia was detected in 71 patients (34,9%), including 20 patients with hypercholesterolemia; 10 with hyperbetalipoproteinemia; 11 with hypertriglyceridemia;30 with combined hyperlipidemia. We determined that 48 patients (67,6%) with dyslipidemia had a poor glycemic control, 13 patients(18,3%) had a suboptimal glycemic control and 10(14,1%) had an optimal control. Dyslipidemia was most common in the last 2 groups of children. The value of Pearson correlation coefficient between HbA1c andβ-lipoproteins level was +0,33, which means there is a moderate positive correlation between the value of HbA1c and the frequency of dyslipidemia. Conclusions. Children older than 15 years and children between 12 and 15 years old have the worst control of diabetes. There is an association of dyslipidemia with poor metabolic control. It’s recommended to determine the lipid profile in patients with type 1 DM.