Hyperlipidemia in children with type 2 diabetes mellitus

Atherosclerosis is the leading cause of morbidity and mortality in patients with type 2 diabetes mellitus (DM). The increased risk of coronary artery disease in patients with type 2 DM is partly due to the lipoprotein abnormalities associated with DM. Dyslipidemia outweighs all other risk factors for cardiovascular disease in adults with type 2 DM. Hypertriglyceridemia and low levels of high-density lipoprotein (HDL)-cholesterol are the most common abnormalities in adults with type 2 DM. These abnormalities may improve, but commonly persist, after optimal glycemic control has been achieved. Children with type 2 DM also have hypertriglyceridemia, low levels of HDL-, as well as elevated levels of total and low-density lipoprotein (LDL)-cholesterol levels. Screening for dyslipidemia is recommended in children with type 2 DM. Several adult clinical trials that included patients with DM have demonstrated the efficacy of lowering LDL-cholesterol in preventing death from coronary artery disease. Weight loss, changing dietary habits, increasing physical activity, and improving glycemic control are initial approaches to the treatment of hyperlipidemia in children with type 2 DM. When goals are not met, drug therapy should be considered.