Lipid and Lipoprotein Levels in Patients With IDDM: Diabetes Control and Complication Trial Experience

Abstract

Objective To compare lipid and lipoprotein levels in patients with insulin-dependent diabetes mellitus (IDDM) with values in similarly aged nondiabetic subjects and analyze the effects of demographic variables, metabolic control, and other factors on the lipid and lipoprotein levels in the diabetic population. Research Design and Methods Fasting total cholesterol, triglyceride, low-density lipoprotein (LDL) cholesterol, and high-density lipoprotein (HDL) cholesterol levels measured during screening for the Diabetes Control and Complications Trial (DCCT) in 1569 generally healthy IDDM patients, between the ages of 13 and 40 yr and with 1–15 yr diabetes duration, were compared with values obtained with similar methods in the Lipid Research Clinics (LRC) prevalence study of nondiabetic individuals. Results When similarly aged groups of IDDM and nondiabetic subjects were compared, higher total and LDL cholesterol and lower HDL cholesterol lipid profiles were restricted to younger (13–24 yr) female diabetic subjects. In general, IDDM males and older IDDM females had similar or slightly less atherogenic profiles than similarly aged nondiabetic subjects. Metabolic control, measured by HbA1c, and body weight (% of ideal body wt) correlated positively with total cholesterol, LDL cholesterol, and triglyceride levels. Conclusions Lipid and lipoprotein levels in the generally healthy IDDM volunteers for the DCCT are similar to those in the nondiabetic population. More atherogenic profiles were present only in younger IDDM women compared with nondiabetic women. The differences between the DCCT data and older studies that demonstrated more profound abnormalities in lipid levels in IDDM populations may reflect patient selection and/or changes in dietary patterns (higher-carbohydrate and lower-fat content) and in glucose control that has occurred in recent years.