We assessed the response of lipid profile to short-term non-pharmacological intervention and investigated if lipoprotein abnormalities were present before overt diabetic nephropathy (DN) in 46 type 1 diabetic (DM1) youngsters aged 15.5±1.5 yrs. They were submitted to a 8-day program of adequate diet and exercise, during stable glycemic control (mean glycemia 110.3±27.1mg/dl and HbA1c 6.9±1.3%) to minimize the influence of disturbed glucose homeostasis on urinary albumin excretion and lipid profile. Mean albumin-to-creatinine ratio was 9.0±8.0mg/g creatinine. At the beginning of the program, 65% of the subjects had total cholesterol > 160mg/dl (95% CI 0.51-0.78), whereas only 38% (95% CI 0.51-0.24) maintained such levels at the end. The improvement in lipid profile was even better concerning LDL fraction, considering that initially 67% of the subjects showed values > 100mg/dl (95% CI 0.55-0.78) and 24% (95% CI 0.12-0.36) at the end. Initial HDL-cholesterol was < 40mg/dl in 38% (95% CI 0.24-0.51) and in 11% (95% CI 0.02-0.20) at the end. In addition, HDL-cholesterol increased significantly. Poor correlations were found between albumin-to-creatinine ratio and total cholesterol (r= 0.21), LDL (r= 0.24), VLDL (r= 0.31), HDL (r= -0.17) and triglycerides levels (r= 0.31). A regular exercise program is effective on optimizing lipid profile in DM1 youngsters independently of glycemic control. Since within the normal range of albuminuria no association of urinary albumin excretion and lipids was found in subjects with stable DM1, our data did not support that lipid metabolism changes might precede microalbuminuria in the course of DN.
Type 1 diabetes mellitus; Lipid profile; Exercise; Urinary albumin excretion
