
August 27, 2003
Other Illnesses
Question from Montauk, New York, USA:
My 11 year old son has had type 1 diabetes for about two and a half years, and he is is currently using an insulin pump. He is very compliant and cooperative with his diabetes care, and his current A1c is 6.4%. He is extremely active, 5 feet tall, and about 95 pounds. Although he is very careful with his diet, he has continually had high cholesterol. His HDL (good) cholesterol is high, and his LDL (bad) cholesterol is low. His “ratio” is also very low. His overall cholesterol runs 300-340 mg/dl!
We see a dietitian on a regular basis, and he eats very little fat, white flour, red meat, etc. His original cholesterol levels were even higher, but they have come down over 100 points since his very first test (438 mg/dl). We have tried everything in our power to get these numbers down without medication, but unfortunately we have not been able to succeed.
His endocrinologist does not feel there is a correlation between type 1 diabetes in children and high cholesterol and that my son needs to begin taking medication for this condition. Although we are concerned about long term effects of these medications, we do not believe we have much of a choice. We do have a family history of high cholesterol but never numbers like we are seeing with my son.
I am curious to know if many of your readers with type 1 diabetes have had cholesterol problems. I would also like you to forward any information you may have on children with diabetes taking cholesterol lowering medications, and what your experts may feel about this situation. If they do agree that medication is our only option, is there one in particular that would be safer for children?
Answer:
Cholesterol control is important in diabetes, and an hemoglobin A1c of 6.4% isn’t contributing to the number. Your son’s problem appears to be familial and diet won’t make it okay. Cholesterol lowering medications are approved for use in children over the age of eight, and your son will need a pretty good dose. I use Pravachol in children. It’s the “gentlest” probably, and not as strong. I would use a small dose and then add Zetia, a cholesterol blocker.
LD