Table 2.

Effect of current therapeutic strategies on dyslipidemia in type 2 diabetes in children

Medication/therapeutic strategy (references)	TG/VLDL-C	HDL-C	LDL-C	Comments
Low-carbohydrate diet [79–81]	↓	↑	↔/↑	Mostly cohort studies with short term data
Mediterranean diet [82, 83]	↓	↑	↓	Mostly cohort studies with short term data
Insulin [52, 53, 84]	↓	↑	↔	Significant when A1C ≤ 8%
Metformin [52, 53, 84, 85]	↓	Mild ↑	↓	TODAY study: 55.9% of the youth remained at the LDL-C goal of < 100 mg/dL over the first 3 years. Levels of TG, apo B, and non-HDL-C rose from baseline to the end of the first year and remained at a higher level for the next 2 years. Only improved glycemic control and weight loss have been associated with improvement in lipid levels
Liraglutide [86, 87]	↓	↔	↔	No differences were apparent in longer term studies. Unclear if the results due mostly normal lipids at baseline/limited sample size
Bariatric surgery [88–92]	↓	↑	Mild ↓	Minor complications were higher in adolescent studies.

TG triglyceride, VLDL-C very low-density lipoprotein cholesterol, HDL-C high-density lipoprotien cholesterol, LDL-C low-density lipoprotein cholesterol