881 PLASMA LIPID LEVELS IN INSULIN DEPENDENT DIABETES: CORRELATION TO CONTROL

Recent reports observed that 20-50% of insulin dependent diabetic children have hyperlipidemia. A study of the insulin dependent diabetic population at this center detected an incidence not significantly different from the general population. The reason for the discrepancy was investigated. Forty-seven diabetics (age 2.5-19.3 yr) had a mean plasma triglyceride of 55±33 mg/dl compared to 56±38 mg/dl for a normal control population. The mean cholesterol was 164±38 mg/dl, significantly less than the 183±26 mg/dl of normal controls. Three patients had cholesterol >220 or triglyceride >140 mg/dl giving an incidence of hyperlipidemia of 6.4% compared to 5.7% for the normal controls. The patients were divided into groups based on adequacy of control of the diabetes. The poor control group was older but the duration of diabetes, male/female ratio, % of ideal body weight, insulin dosage, and excess calorie and carbohydrate intake did not differ among the groups. The poor control group's diet was characterized by higher fat, lower protein and higher cholesterol intake. The major distinction between this diabetic population and those with elevated lipids was prescribed versus “free” diet. We conclude that: 1) hyperlipidemia is not necessarily a concomitant of insulin dependent diabetes, and 2) composition of the diet is the major determinant of plasma lipid levels in insulin dependent diabetics maintained in a reasonable degree of control.