Category: Diabetes/Prediabetes/Hypoglycemia

Monitor: 19

19 - DYSLIPIDEMIA IN CHILDHOOD TYPE 1 DIABETES IN INDIA: PREVALENCE CORRELATES AND MANAGEMENT CHALLENGES IN A RESOURCE LIMITED SETTING

Thursday, Apr 25
11:00 AM – 11:30 AM

Objective : To study prevalence, clinical correlates and management challenges of dyslipidemia in children with type 1 diabetes.


Methods :

DISHA Free Diabetes Clinic for the Poor [1987 – Ongoing]:  Since 2011, 386 children are receiving enhanced support - free insulin [Basal bolus insulin (meal time regular + bedtime NPH) 100%], syringes, health counselling, 24 h help lines, BG meters, 30 BG strips/ month and limited biochemical evaluations [TSH, quarterly HbA1c, annual urine albumin: creatinine ratio] [Changing Diabetes in Children and Life for a Child with Diabetes].  From this cohort, 120 children (Male 39%) were randomly selected for the analysis. 


Results : [Mean] DM Duration= 7.8 y; DM Age Onset= 10.4 y; Height= 147 Cm; Weight= 45.9 Kg; BMI= 20.7; Pulse Rate= 100; BP= 113/70; Hemoglobin Hb= 12.9 G/dl; HBA1c= 9.5%; Serum Albumin S Alb= 3.9 mg/dl; Urine Albumin Creatinine Ratio UACR= 59 mcg/mg; Serum Creatinine S Creat= 0.61 mg/dl; eGFR= 122 mL/min/1.73 m2. Retinopathy: Non-proliferative: 3%; Proliferative 1%.  On ACE inhibitors / ARB = 25%.  Acute myocardial infarction: One 20 y girl with T1DM from age 4y.  Statin therapy= 5%


 


 


 


HbA1c     HbA1C%   T Chol  LDL Chol HDL Chol  Trig  [mg/dl]
Group


 


< 8            7.1             174       93             57               113


 


8 - 10        8.9             199       101           59               193


 


>10           11.9            216      104           52                293

P               <0.0001__ 0.01_________________       <0.0001


Discussion :

In this cohort of “poverty associated” type 1 diabetes children, “Good” glycemic control was associated with: Lower Total [and LDL] Cholesterol, Lower Triglycerides, and Higher HDL Cholesterol.


Conclusion :

Philanthropy based highest possible standards of medical care, resulted in improvements in glycemic control and lipid profiles, bestowing future long term positive cardiovascular health benefits, for these young ones. Guidelines based treatment for dyslipidemia in pediatric/ adolescent diabetes needs stronger focus.

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Chandraprabha S

Consultant Faculty Endocrinology Diabetes
Samatvam Jnana Sanjeevini Diabetes Hospital and Medical Center
Bangalore, Karnataka, India

Designation: Consultant and Faculty
Specialties: Endocrinology Diabetes Metabolism
Clinical Interests: Pregnancy Diabetes, Pregnancy Thyroid Dysfunction, Women Health, Geriatric Endocrinology, Diabetes mellitus and Mental Health, Spiritual Medicine

Jayalakshmi T

Consultant Faculty Endocrinology Diabetes
Samatvam Jnana Sanjeevini Diabetes Hospital and Medical Center
Bangalore, Karnataka, India

Designation: Consultant and Faculty

Specialties: Endocrinology, Diabetes, Internal Medicine,
Clinical Interests: Diabetes mellitus, Cardiovascular Health, Thyroid, In Patient Diabetes Care, Endocrinology Metabolic emergencies and critical care

Reshma B. Vijay

Consultant Faculty Endocrinology Diabetes
Samatvam Jnana Sanjeevini Diabetes Hospital and Medical Center
Bangalore, Karnataka, India

Designation: Consultant and Faculty
Specialties: Endocrinology Diabetes and Metabolism
Clinical Interests: Pediatric Endocrinology; Diabetes mellitus; Insulin Pumps, Continuous Glucose Monitoring and Artificial Pancreas; Growth and Puberty; Thyroid; Pituitary Adrenal disorders

Kavitha Muniraj

Consultant Faculty Endocrinology Diabetes
Samatvam Jnana Sanjeevini Diabetes Hospital and Medical Center
Bangalore, Karnataka, India

Designation: Consultant and Faculty; Director Medical ; Director Research; Trustee
Specialties: Endocrinology Diabetes; Clinical Research
Clinical Interests: Pituitary Adrenal disorders; Bone health; Cardiovascular Health; Thyroid dysfunction; Diabetes Pharmacotherapy; Clinical Pharmacology; Pharmacovigilance; Clinical research Safety and Audits

Muralidhara Krishna

Consultant Faculty Endocrinology Diabetes Biochemistry
Samatvam Jnana Sanjeevini Diabetes Hospital and Medical Center
Bangalore, Karnataka, India

Designation: Consultant and Faculty: Endocrinology Diabetes Metabolism; Associate Professor: Clinical Biochemistry and Laboratory Medicine
Specialties: Endocrinology Diabetes Metabolism; Clinical Biochemistry
Clinical Interests: Diabetes mellitus; Thyroid Disorders; Obesity; Dyslipidemia.

Apoorva Govind

Consultant Faculty Endocrinology Diabetes
Samatvam Jnana Sanjeevini Diabetes Hospital and Medical Center
bangalore, Karnataka, India

Designation: Resident
Specialties: Endocrinology, Diabetes, Internal Medicine, Pediatrics
Clinical Interests: Diabetes mellitus, Cardiovascular Health, Thyroid, Pediatric Diabetes Endocrinology

Madhumati S Vaishnav

Scientist Faculty
Samatvam Jnana Sanjeevini Diabetes Hospital and Medical Center; CENSE Indian Institute of Science, India

B.Sc (Microbiology), University of Pune, India.
M.Sc (Microbiology), University of Pune, India.
Post Graduate Diploma in Clinical Research and Clinical Data Management, University of Pune, India
CDE (Certified Diabetes Educator - Counselor), Samatvam Institute of Medical Sciences, India

Babitha D. T

Consultant Faculty Endocrinology Diabetes
Samatvam Jnana Sanjeevini Diabetes Hospital and Medical Center
Bangalore, Karnataka, India

Designation: Consultant and Faculty
Specialties: Endocrinology, Diabetes
Clinical Interests: Endocrine disorders of pregnancy, Pregnancy Diabetes, Cardiovascular Health, Thyroid, Inpatient diabetes care and endocrine metabolic emergencies

Vasanthi Nath

Consultant Faculty Endocrinology Diabetes
Samatvam Jnana Sanjeevini Diabetes Hospital and Medical Center
Bangalore, Karnataka, India

Designation: Consultant and Faculty
Specialties: Endocrinology, Diabetes, Internal Medicine, Geriatrics
Clinical Interests: Neuroendocrinology and Neurometabolism, Metabolic Myopathies; Thyroid tumors, Geriatric Endocrinology, Inpatient Diabetes Care and Endocrine Emergencies; Type 1 diabetes across ages

Nidhi Garg

Consultant Faculty Endocrinology Diabetes
Samatvam Jnana Sanjeevini Diabetes Hospital and Medical Center
bangalore, Karnataka, India

Designation: Senior Consultant and Faculty
Specialties: Diabetes and Metabolism
Clinical Interests: Comprehensive diabetes care, In-patient diabetes and metabolic care, Perioperative diabetes management, Diabetes and endocrine emergencies – Metabolic Intensive Care, Obesity management, Lipids and preventive cardiology, Gestational diabetes, Thyroid disorders, Type 1 diabetes across ages

MD Chitra

Consultant Faculty Endocrinology Diabetes
Samatvam Jnana Sanjeevini Diabetes Hospital and Medical Center

Designation: Consultant and Faculty; Trustee
Specialties: Endocrinology Diabetes; Clinical Research
Clinical Interests: Diabetes, Obesity, Dyslipidemia, Osteoporosis, Pituitary Adrenal disorders; Bone health; Cardiovascular Health; Thyroid dysfunction;

Vasudha Srikanth


India

Monica Narayanaswamy

Resident doctor
Samatvam jnana sanjeevini diabetes hospital and medical centre
Chintamani, India

Nalini Rayas

Keerthana Haridas

Namya Gaekwad

Sri Srikanta