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©2013 UpToDate ® Print Email Management of dyslipidemia in children and adolescents with diabetes Screening Type 1 Obtain lipid profile at diagnosis (after glycemic control is well established). If normal, repeat every 5 years. • Begin at age 10 years (or onset of puberty, if earlier) • Begin prior to age 10 years if there is a family history of early cardiovascular disease, or if child is overweight or obese Type 2 Obtain lipid profile at diagnosis (after glycemic control is well established). If normal, repeat every 2 years. Monitoring If lipids are abnormal, annual monitoring is recommended If LDL cholesterol values are within the accepted risk levels (<100 mg/dL [2.6 mmoL/L]), a lipid profile should be repeated every 5 years for type 1 diabetes, or every 2 years for type 2 diabetes Goals LDL <100 mg/dL HDL >35 mg/dL Triglycerides <150 mg/dL Treatment strategies Diet: Step 2 AHA diet, aimed to decrease intake of saturated fat Maximize glycemic control Weight reduction, if indicated Medications Indications: Age >10 years AND LDL ≥160 mg/dL, OR LDL 130-159 mg/dL if other risk factors for CVD Statins ± resins Fibric acid derivatives if triglycerides >1000 mg/dL Manage other CVD risk factors Blood pressure Tobacco Obesity Inactivity LDL: low-density lipoprotein; HDL: high-density lipoprotein; CVD: cardiovascular disease; AHA: American Heart Association. Reproduced with permission from: American Diabetes Association. Management of dyslipidemia in children and adolescents with diabetes. Diabetes Care 2003; 26:2194. Copyright © 2003 American Diabetes Association. Modified based on 2008 ADA guidelines.