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March 1, 2006

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Question from Rutland, Massachusetts, USA:

My five year old son just went to his three month visit for his A1c and had blood drawn for a cholesterol check. I just received his results and the cholesterol is 195. The nurse practitioner stated that the HDL level is "great" and the LDL level is "slightly high, but cardiac risk is very low once everything is calculated." My son was eating his lunch just five minutes before the blood draw (peanut butter sandwich and a chocolate chip cookie). How accurate can these results be? Also, how concerned should I be about his cholesterol being 195 and his LDL being slightly high? My son has had type 1 diabetes for a little over one year. He is thin and active. He is also a very picky eater, so altering his diet even further may pose a challenge. The nurses were not able to do his thyroid antibodies test because of problems when drawing blood. His A1c was excellent, but I was discouraged to see his cholesterol number. Any advice you can offer would be greatly appreciated.

Answer:

Blood cholesterol levels should be always tested in the fasting state and all reference values are referring to the fasting values. That said, a total cholesterol level of 195 with a “great” HDL and a slightly elevated LDL is very probably not so bad a lipid profile. And, if his A1c is excellent as you write, I wouldn’t worry too much, although even a prudent low fat “Mediterranean-type” diet should always be preferred, when compared to the standard U.S. diet, for a kid with type 1 diabetes.

MS