From Florida, USA:
Given the cardiovascular risk factors of type 1 diabetes, is it worthwhile to test and treat hyperlipidemia? Should a person with type 1 take a baby aspirin, biotin, fish oil, other antioxidants, etc.? Is there a panel of blood tests for overall diabetes health, such as microalbumin, etc.? How often should these test be done?
In articles that I have written reviewing diabetes complications in pediatric and adolescent diabetes, and in guidelines by ISPAD, IDF, ADA etc., unfortunately, there is no good consensus or sufficient long term research to answer your questions. What we actually do with our own patients is as follows and seems prudent, but you should discuss this specifically with your diabetes team so that this is individualized.
Usually, we start with 81 mg of buffered aspirin, plus an all purpose multiple vitamin/mineral such as Theragram M or Centrum A-Z, but usually only after age 18. Some people do not do this at all and others wait until age 21. Both can be done inexpensively and there are good generic versions available.
We check lipids annually from diagnosis onwards and, depending upon family history, sometimes add a lipid lowering agent such as Lipitor in early adolescence. The higher the LDL and total cholesterol and the more positive the family history, the earlier we start such treatment. There is good data from Cincinnati Children's Lipid Clinics about the safety profile of Lipitor with side effects about the same as for adults: liver, muscle and gastrointestinal upsets. More than 85% of kids treated in this fashion in our center do not have such side effects.
Other antioxidants have even less solid long-term research and, so, we have no definite recommendations.
We, and most others, start checking for blood pressure and kidney problems routinely at the time of puberty with timed overnight urine for microalbumin and, as with lipids, if there is positive family history of hypertension, stroke, heart problems or if the blood pressure remains elevated persistently and/or there is microalbuminuria on three or more timed samples, then we would add an ACE inhibitor such as lisinopril as well.
Original posting 2 Jan 2007
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Last Updated: Tuesday April 06, 2010 15:10:10
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