Awareness and Treatment of Dyslipidemia in Young Adults With Type 1 Diabetes

  1. R. Paul Wadwa, MD1,
  2. Gregory L. Kinney, MPH2,
  3. David M. Maahs, MD1,
  4. Janet Snell-Bergeon, MPH2,
  5. John E. Hokanson, PHD2,
  6. Satish K. Garg, MD1,
  7. Robert H. Eckel, MD3 and
  8. Marian Rewers, MD, PHD1
  1. 1Barbara Davis Center for Childhood Diabetes, University of Colorado Health Sciences Center, Denver, Colorado
  2. 2Department of Preventive Medicine and Biometrics, University of Colorado Health Sciences Center, Denver, Colorado
  3. 3Department of Medicine, University of Colorado Health Sciences Center, Denver, Colorado
  1. Address correspondence and reprint requests to R. Paul Wadwa, MD, Barbara Davis Center for Childhood Diabetes, University of Colorado Health Sciences Center, 4200 East 9th Ave., Box B140, Denver, CO 80262. E-mail: paul.wadwa{at}uchsc.edu

Abstract

OBJECTIVE—Dyslipidemia is a preventable major risk factor for coronary heart disease (CHD). Despite an increased risk of CHD in type 1 diabetes, little is known concerning awareness and adequacy of dyslipidemia treatment in this population. In this report, we describe the prevalence of dyslipidemia and adequacy of pharmacological treatment in patients with type 1 diabetes and comparable nondiabetic subjects.

RESEARCH DESIGN AND METHODS—From 2000 to 2002, the Coronary Artery Calcification in Type 1 Diabetes study obtained fasting lipid profiles in 1,416 individuals aged 19–56 years with no history of CHD: 652 type 1 diabetic patients (46% men, mean age 37 ± 9 years) and 764 nondiabetic control subjects (50% men, mean age 39 ± 9 years). These data combined with patient questionnaire results were used to determine prevalence of dyslipidemia and adequacy of pharmacological treatment. For all subjects, dyslipidemia was defined using National Cholesterol Education Program Adult Treatment Panel III criteria.

RESULTS—Type 1 diabetic subjects had significantly less dyslipidemia than nondiabetic control subjects (47 vs. 58%, P < 0.001), and a higher percentage of those with abnormal lipids were aware of (52 vs. 34%, P < 0.0001), on medication for (36 vs. 9%, P < 0.0001), and in control of their lipid levels (15 vs. 1.4%, P < 0.001). Of those on treatment, control was achieved in 41% of type 1 diabetic subjects and 15% of nondiabetic participants (P < 0.01).

CONCLUSIONS—Dyslipidemia, a major risk factor for CHD, remains largely undiagnosed and undertreated in high-risk populations, such as patients with type 1 diabetes.

Footnotes

  • R.F. has received honoraria from Merck, Pfizer, and KOS, and has received grant/research support from Merck.

    A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.

    • Accepted February 6, 2005.
    • Received September 2, 2004.
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