Key result
Dyslipidemia is highly prevalent in pediatric type 2 diabetes, and management involves optimizing glycemic control followed by statin or fibrate therapy for persistent lipid abnormalities.
Why the study?
Cardiovascular disease is a major cause of mortality in T2D, and dyslipidemia is prevalent in children with T2D and a known risk factor for CVD.
This review highlights the importance of screening and managing dyslipidemia in pediatric type 2 diabetes to mitigate cardiovascular risk, outlining specific lipid targets and pharmacological interventions.
Emphasizes CV risk mitigation in youth-onset diabetes; leaves open pediatric outcome data for lipid-lowering therapy.
PURPOSE OF REVIEW: Cardiovascular (CV) disease is a major cause of mortality in type 2 diabetes mellitus (T2D). Dyslipidemia is prevalent in children with T2D and is a known risk factor for CVD. In this review, we critically examine the epidemiology, pathophysiology, and recommendations for dyslipidemia management in pediatric T2D. RECENT FINDINGS: Dyslipidemia is multifactorial and related to poor glycemic control, insulin resistance, inflammation, and genetic susceptibility. Current guidelines recommend lipid screening after achieving glycemic control and annually thereafter. The desired lipid goals are low-density lipoprotein cholesterol (LDL-C) < 100 mg/dL, high-density lipoprotein cholesterol (HDL-C) > 35 mg/dL, and triglycerides (TG) < 150 mg/dL. If LDL-C remains > 130 mg/dL after 6 months, statins are recommended with a treatment goal of < 100 mg/dL. If fasting TG are > 400 mg/dL or non-fasting TG are > 1000 mg/dL, fibrates are recommended. Although abnormal levels of atherogenic TG-rich lipoproteins, apolipoprotein B, and non-HDL-C are commonly present in pediatric T2D, their measurement is not currently considered in risk assessment or management.
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Sunil et al. (2020) conducted a review in Dyslipidemia in Pediatric Type 2 Diabetes Mellitus. Dyslipidemia is highly prevalent in pediatric type 2 diabetes, and management involves optimizing glycemic control followed by statin or fibrate therapy for persistent lipid abnormalities.