Document Type : Original Article


1 Community and Family Medicine Department, Isfahan University of Medical Sciences, Isfahan University of Medical Sciences

2 Pediatric Pulmonology, Isfahan University of Medical Sciences, Isfahan, Iran


BACKGROUND: Type 1 diabetes mellitus (T1DM) and its related comorbidities are considered an
important health issue. This study aimed to evaluate the impact of glycemic control on lipid profile
variables in children with T1DM.
MATERIALS AND METHODS: This study included 274 children (≤19 years of age) with T1DM who
had referred to the outpatient clinics of endocrinology in Emam‑Hossein Hospital of Isfahan, Iran.
Based on American Diabetes Association criteria, patients were divided into two groups including
optimal glycemic control (OGC) and poor glycemic control (PGC). Mean lipid level and frequencies
of lipid profile abnormalities between the two studied groups were compared.
RESULTS: Mean age of the studied population was 13 ± 5.9 years and 133 (48.5%) were boys. A total
of 162 (59.1%) and 112 (40.9%) patients had PGC and OGC, respectively. Hypercholesterolemia was
the most common dyslipidemia in both groups (33 [29.1%] of OGC and 63 [39.1%] of PGC patients).
The frequency of high low‑density lipoprotein (LDL) was significantly higher in patients with PGC
than those with OCG (P = 0.007). The frequencies of hypercholesterolemia, hypertriglyceridemia,
and low levels of high‑density lipoprotein were also higher in PGC group, but did not reach the
significant threshold.
CONCLUSION: It is suggested that glycemic control is in association with lipid profile abnormality
in patients with T1DM. High LDL was significantly more frequent in patients with PGC than those
with OGC. It is recommended to investigate the role of glycemic control on other cardiometabolic
risk factors of T1DM patients. Our findings could be used for planning preventative strategies for
reducing T1DM‑related cardiovascular disease.


  1. Maahs DM, West NA, Lawrence JM, Mayer‑Davis EJ.
    Epidemiology of type 1 diabetes. Endocrinol Metab Clin North
    Am 2010;39:481‑97.
    2. Kelishadi R, Motlagh ME, Roomizadeh P, Abtahi SH, Qorbani M,
    Taslimi M, et al. First report on path analysis for cardiometabolic
    components in a nationally representative sample of pediatric
    population in the Middle East and North Africa (MENA): The
    CASPIAN‑III study. Ann Nutr Metab 2013;62:257‑65.
    3. Tan T, Xiang Y, Chang C, Zhou Z. Alteration of regulatory T cells
    in type 1 diabetes mellitus: A comprehensive review. Clin Rev
    Allergy Immunol 2014;47:234‑43.
    4. Krantz JS, Mack WJ, Hodis HN, Liu CR, Liu CH, Kaufman FR,
    et al. Early onset of subclinical atherosclerosis in young persons
    with type 1 diabetes. J Pediatr 2004;145:452‑7.
    5. Lee SI, Patel M, Jones CM, Narendran P. Cardiovascular disease
    and type 1 diabetes: Prevalence, prediction and management in
    an ageing population. Ther Adv Chronic Dis 2015;6:347‑74.
    6. Kim SH, Jung IA, Jeon YJ, Cho WK, Cho KS, Park SH, et al. Serum
    lipid profiles and glycemic control in adolescents and young
    adults with type 1 diabetes mellitus. Ann Pediatr Endocrinol
    Metab 2014;19:191‑6.
    7. Giuffrida FM, Guedes AD, Rocco ER, Mory DB, Dualib P,
    Matos OS, et al. Heterogeneous behavior of lipids according to
    hbA1c levels undermines the plausibility of metabolic syndrome
    in type 1 diabetes: Data from a nationwide multicenter survey.
    Cardiovasc Diabetol 2012;11:156.
    8. Fatani SH, Babakr AT, NourEldin EM, Almarzouki AA. Lipid
    peroxidation is associated with poor control of type‑2 diabetes
    mellitus. Diabetes Metab Syndr 2016;10:S64‑7.
    9. Mishra N, Singh N. Blood viscosity, lipid profile, and lipid
    peroxidation in type‑1 diabetic patients with good and poor
    glycemic control. N Am J Med Sci 2013;5:562‑6.
    10. Feitosa AC, Feitosa‑Filho GS, Freitas FR, Wajchenberg BL,
    Maranhão RC. Lipoprotein metabolism in patients with type 1
    diabetes under intensive insulin treatment. Lipids Health Dis
    11. Shamir R, Kassis H, Kaplan M, Naveh T, Shehadeh N. Glycemic
    control in adolescents with type 1 diabetes mellitus improves
    lipid serum levels and oxidative stress. Pediatr Diabetes
    12. Vaid S, Hanks L, Griffin R, Ashraf AP. Body mass index and
    glycemic control influence lipoproteins in children with type 1
    diabetes. J Clin Lipidol 2016;10:1240‑7.
    13. Alberti KG, Zimmet PZ. Definition, diagnosis and classification
    of diabetes mellitus and its complications. Part 1: Diagnosis and
    classification of diabetes mellitus provisional report of a WHO
    consultation. Diabet Med 1998;15:539‑53.
    14. American Diabetes Association. Standards of medical care in
    diabetes‑‑2014. Diabetes Care 2014;37 Suppl 1:S14‑80.
    15. Schwab KO, Doerfer J, Hecker W, Grulich‑Henn J, Wiemann D,
    Kordonouri O, et al. Spectrum and prevalence of atherogenic risk
    factors in 27,358 children, adolescents, and young adults with
    type 1 diabetes: Cross‑sectional data from the German diabetes
    documentation and quality management system (DPV). Diabetes
    Care 2006;29:218‑25.
    16. al‑Naama LM, Kadhim M, al‑Aboud MS. Lipid profile in children
    with insulin dependent diabetes mellitus. J Pak Med Assoc
  2. 17. Rahma S, Rashid JA, Farage AH. The significance of lipid
    abnormalities in children with insulin dependent diabetes
    mellitus. Iraqi Postgrad Med J 2006;5:289–94.
    18. Zabeen B, Balsa AM, Islam N, Parveen M, Nahar J, Azad K, et al.
    Lipid profile in relation to glycemic control in type 1 diabetes
    children and adolescents in Bangladesh. Indian J Endocrinol
    Metab 2018;22:89‑92.
    19. Herman WH, Aubert RE, Engelgau MM, Thompson TJ, Ali MA,
    Sous ES, et al. Diabetes mellitus in Egypt: Glycaemic control
    and microvascular and neuropathic complications. Diabet Med
    20. Kantoosh MM, Naiem AM, El‑Sayad M, Nashat M. Dyslipidemia
    and lipid peroxidation in type 1 diabetic children with good
    glycemic control: Response to antioxidant therapy. Alex J Pediatr
    21. van Vliet M, van der Heyden JC, Diamant M, von Rosenstiel IA,
    Schindhelm RK, Heymans MW, et al. Overweight children
    with type 1 diabetes have a more favourable lipid profile than
    overweight non‑diabetic children. Eur J Pediatr 2012;171:493‑8.
    22. Guy J, Ogden L, Wadwa RP, Hamman RF, Mayer‑Davis EJ,
    Liese AD, et al. Lipid and lipoprotein profiles in youth with and
    without type 1 diabetes: The SEARCH for diabetes in youth
    case‑control study. Diabetes Care 2009;32:416‑20.
    23. Maahs DM, Wadwa RP, McFann K, Nadeau K, Williams MR,
    Eckel RH, et al. Longitudinal lipid screening and use of
    lipid‑lowering medications in pediatric type 1 diabetes. J Pediatr
    2007;150:146‑50, 150.e1‑2.
    24. Nathan DM, Cleary PA, Backlund JY, Genuth SM, Lachin JM,
    Orchard TJ, et al. Intensive diabetes treatment and cardiovascular
    disease in patients with type 1 diabetes. N Engl J Med
    25. Delamater A. Clinical use of hemoglobin A1c to improve diabetes
    management. Clin Diabetes 2006;24:6‑8.
    26. American Association of Clinical Endocrinologists. The American
    Association of Clinical Endocrinologists medical guidelines for the
    management of diabetes mellitus: The AACE system of intensive
    diabetes self‑management‑2000 update. Endocr Pract 2000;6:43‑84.
    27. Hoerger TJ, Segel JE, Gregg EW, Saaddine JB. Is glycemic control
    improving in U.S. Adults? Diabetes Care 2008;31:81‑6.
    28. Spellman CW. Achieving glycemic control: Cornerstone in the
    treatment of patients with multiple metabolic risk factors. J Am
    Osteopath Assoc 2009;109:S8‑13.