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Dietary Fats Do Not Contribute to Hyperlipidemia in Children and Adolescents With Type 1 Diabetes

¹ Department of Diabetes and Endocrinology, Women’s and Children’s Hospital, North Adelaide, Australia
² Public Health Research Unit, Women’s and Children’s Hospital, North Adelaide, Australia
³ Department of Paediatrics, University of Adelaide, North Adelaide, Australia

OBJECTIVE—To determine the relative influence of diet, metabolic control, and familial factors on lipids in children with type 1 diabetes and control subjects.

RESEARCH DESIGN AND METHODS—We assessed fasting serum cholesterol, LDL cholesterol, HDL cholesterol, triglycerides, lipoprotein(a), apolipoprotein (apo)-A1, and apoB in 79 children and adolescents with type 1 diabetes and 61 age- and sex-matched control subjects, together with dietary intakes using a quantitative food frequency questionnaire.

RESULTS—Total cholesterol, LDL cholesterol, apoB, HDL cholesterol, and apoA1 were significantly higher in children with diabetes. Children with diabetes had higher percentage energy intake from complex carbohydrates (P = 0.001) and fiber intake (P = 0.02), and they had lower intake of refined sugar (P < 0.001) and percentage energy from saturated fat (P = 0.045) than control subjects. Total cholesterol (ß = 0.43, P < 0.001), LDL cholesterol (ß = 0.4, P < 0.001), and apoB (ß = 0.32, P = 0.006) correlated independently with HbA_1c but not dietary intake. HDL cholesterol (ß = 0.24, P = 0.05) and apoA1 (ß = 0.32, P = 0.004) correlated independently with HbA_1c, and HDL cholesterol (ß = -0.34, P = 0.009) correlated with percentage energy intake from complex carbohydrates. Triglycerides correlated independently with percentage energy intake from complex carbohydrates (ß = 0.33, P = 0.01) and insulin dose (ß = 0.26, P = 0.04). Subjects with diabetes and elevated LDL (>3.35 mmol/l, >130 mg/dl), for whom dietary therapy would be recommended, had significantly higher HbA_1c (P = 0.007), but they had higher intake of complex carbohydrates than subjects with LDL cholesterol <3.35 mmol/l.

CONCLUSIONS—Lipid abnormalities remain common in children and adolescents with type 1 diabetes who adhere to current dietary recommendations, and they relate to metabolic control but not dietary intake.

Abbreviations: ADA, American Diabetes Association • apo, apolipoprotein • BP, blood pressure • CV, coefficient of variation • DCCT, Diabetes Control and Complications Trial • FFQ, food frequency questionnaire • ISPAD, International Society for Pediatric and Adolescent Diabetes • Lp(a), lipoprotein(a)

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