Dataset Information

Management of Hypertension and High Low-Density Lipoprotein in Pediatric Type 1 Diabetes.

ABSTRACT:

Objective

To evaluate hypertension and hyperlipidemia management patterns in youth with type 1 diabetes and to assess perceived effectiveness of management strategies and barriers to management.

Study design

An electronic survey, including clinical scenarios, fielded to pediatric providers (members of the American Diabetes Association Diabetes in Youth Interest Group, Pediatric Endocrine Society, or T1D Exchange).

Results

Respondents (N = 207, 86% MDs, 68% female) were practicing clinicians for youth with type 1 diabetes. As an initial recommendation, the overwhelming majority of respondents (83%-99%) endorsed lifestyle and nonmedical recommendations (eg, improve glycemic control) for hypertension and hyperlipidemia. Yet, few (6%-17%) reported these recommendations as effective. Many respondents (57%) reported referring to another specialist for hypertension, whereas few (8%) reported referring to another specialist for hyperlipidemia management. Approximately one-fifth (21%) of respondents never initiate antihypertensive medications, whereas only 8% never initiate lipid-lowering medication. Among prescribers, the majority of respondents only started antihypertensive or lipid-lowering medications after persistent elevations and in the setting of either ineffective lifestyle or nonmedical interventions or additional cardiovascular risk factors. More than two-thirds of respondents endorsed medications as often effective for hypertension and hyperlipidemia (68% and 69%, respectively).

Conclusions

Pediatric diabetes providers commonly defer prescribing antihypertensive and lipid-lowering medications until nonmedication interventions have been ineffective. Most providers describe medications, but not lifestyle interventions, as often effective. Efforts to align clinical practice with clinical guidelines are needed.

SUBMITTER: Katz ML

PROVIDER: S-EPMC6013061 | biostudies-literature | 2018 Jun

REPOSITORIES: biostudies-literature

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Publications

Management of Hypertension and High Low-Density Lipoprotein in Pediatric Type 1 Diabetes.

Katz Michelle L ML Guo Zijing Z Laffel Lori M LM

The Journal of pediatrics 20180201

<h4>Objective</h4>To evaluate hypertension and hyperlipidemia management patterns in youth with type 1 diabetes and to assess perceived effectiveness of management strategies and barriers to management.<h4>Study design</h4>An electronic survey, including clinical scenarios, fielded to pediatric providers (members of the American Diabetes Association Diabetes in Youth Interest Group, Pediatric Endocrine Society, or T1D Exchange).<h4>Results</h4>Respondents (N = 207, 86% MDs, 68% female) were prac ...[more]

PMID: 29395184

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Dataset Information

Management of Hypertension and High Low-Density Lipoprotein in Pediatric Type 1 Diabetes.

Objective

Study design

Results

Conclusions

Publications

Management of Hypertension and High Low-Density Lipoprotein in Pediatric Type 1 Diabetes.

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