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خرید پکیج
تعداد آیتم قابل مشاهده باقیمانده : 3 مورد
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Screening and management of dyslipidemia in adolescents with type 2 diabetes

Screening and management of dyslipidemia in adolescents with type 2 diabetes
Screening
Obtain a lipid profile at diagnosis (after glycemic control is well established). If sample was nonfasting (random) and results are indeterminate, confirm with a fasting lipid panel.
Monitoring:
  • If LDL cholesterol values are within the accepted risk levels (<100 mg/dL [2.6 mmoL/L]), a lipid profile should be repeated annually
  • If lipids are abnormal, more frequent monitoring is recommended
Goals (fasting values)
LDL <100 mg/dL (2.6 mmol/L).
HDL >35 mg/dL (0.9 mmol/L).
Triglycerides <150 mg/dL (1.7 mmol/L).
Treatment strategies
Diet – Step 2 AHA diet, aimed to decrease intake of saturated fat and cholesterol*.
Optimize glycemic control.
Reduce weight.
Increase physical activity.
Pharmacotherapy – Begin after 6 months of nonpharmacologic intervention if above lipid goals are not met (fasting values):
  • LDL ≥130 mg/dL and age >10 years – Begin a statin (HMG-CoA reductase inhibitor)
  • Triglycerides >400 mg/dL (4.5 mmol/L) – Begin fibric acid
Manage other cardiovascular disease risk factors:
  • Blood pressure
  • Tobacco use
  • Obesity
  • Inactivity

LDL: low-density lipoprotein; HDL: high-density lipoprotein; AHA: American Heart Association; HMG-CoA: 3-hydroxy-3-methyl-glutaryl-coenzyme A.

* Diet includes limiting total fat to 25 to 30% of calories, saturated fat <7% of total calories, and dietary cholesterol intake <200 mg/day, avoiding trans fats and aiming to have monounsaturated fats >7% of calories.

¶ Adolescent females on statin therapy should be counseled about the possibility of drug teratogenicity and appropriate contraceptive methods. These drugs should be discontinued immediately if pregnancy is discovered.

Modified with permission from: The American Diabetes Association. Management of dyslipidemia in children and adolescents with diabetes. Diabetes Care 2003; 26:2194. Copyright © 2003.

Updated based on: American Diabetes Association Professional Practice Committee, Draznin B, Aroda VR, et al. 14. Children and Adolescents: Standards of Medical Care in Diabetes-2022. Diabetes Care 2022; 45:S208.
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