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Dyslipidaemia as a target for atherosclerotic cardiovascular disease prevention in children with type 1 diabetes: lessons learned from familial hypercholesterolaemia – published online 30/11/2023

Corpeleijn graphical abstract

Willemijn E. Corpeleijn, Wouter J. de Waal, Henk S. Schipper, Albert Wiegman

Children with onset of type 1 diabetes under 10 years of age have an 11.4-fold increased risk of premature atherosclerotic cardiovascular disease (ASCVD) compared with matched controls. Part of their ASCVD risk is attributed to dyslipidaemia and, similar to children with familial hypercholesterolaemia (FH), lipid-lowering therapy may lower their ASCVD risk. In this issue, Corpeleijn et al (https://doi.org/10.1007/s00125-023-06041-z) describe how, in a 20 year follow-up study of statins in children with FH, early initiation slowed the progression of carotid intima–media thickness and reduced the risk of ASCVD in adulthood. The authors report that, in their 30 years’ experience of statin use in children with FH they have not observed any serious side effects, such as rhabdomyolysis. Notably, statins have been associated with disease progression in type 2 diabetes, which is likely to be due to an increase in peripheral insulin resistance, a hallmark of type 2 diabetes but less of an issue in type 1 diabetes. The authors conclude that there is a strong rationale for early ASCVD risk management in children with type 1 diabetes, including a potential role for statins. The figure from this review is available as a downloadable slide.

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