Management of Hypertension and Hyperlipidemia in Youth with T2D
Authors: BEAULIEU LINDSEY C. , CHENG PEIYAO , KATZ MICHELLE , LAFFEL LORI M. , TAMBORLANE WILLIAM V. , VAN NAME MICHELLE A. , BANSAL NIDHI , KOLLMAN CRAIG , GAL ROBIN L. 
Published: June 2018

Introduction: Youth with T2D are at risk for additional cardiovascular (CVD) diseases such as hypertension (HT) and hyperlipidemia (HLD). We examined healthcare provider (HCP) self-reported practices regarding management and treatment of HT and HLD in youth with T2D.
Methods: An electronic survey collected information from prescribing HCPs from Pediatric Diabetes Consortium sites regarding their usual treatment of and barriers related to treatment of HT and HLD in youth with T2D.
Results: Respondents (N=70) were predominately female (67%) from urban (77%) academic centers (70%). HT and HLD treatment recommendations focused on lifestyle modifications including healthy eating, weight loss, physical activity, dietitian/nutritionist referral, and improving glycemic control. Medication was recommended initially more than half of time to treat HT and HLD (51% and 62%, respectively). If HT or HLD persisted for an additional 6-12 months, &gt;80% of HCPs would choose to add additional treatment. Less than half of HCPs reported that treatment of HT and HLD is generally effective most/all of the time (42% and 34%, respectively). HCPs reported that obstacles to treatment from the patient’s perspective included lack of support to make lifestyle changes (78%), difficulty following-through with lifestyle changes (80%), lack of motivation to control diseases (68%), socioeconomic challenges (62%), and transportation difficulties (54%). Concerns regarding patient adherence (50%) and inability to focus on both diabetes and HT/HDL due to shortness of visits (42%) were the most commonly cited barriers by HCPs.
Conclusion: Given that youth with T2D have high risk of developing CVD complications, HCP approaches to treat both HT and HLD are important. Notably, the majority report their recommendations are ineffective. Patient-related barriers are the biggest challenge to effective treatment; future research should explore ways to mitigate these barriers.

Disclosure
L.C. Beaulieu: Research Support; Self; Novo Nordisk Inc., Boehringer Ingelheim Pharmaceuticals, Inc., Takeda Development Center Americas, Inc.. P. Cheng: None. M. Katz: None. L.M. Laffel: Consultant; Self; Eli Lilly and Company, Novo Nordisk Inc., Sanofi US, MannKind Corporation, Roche Diagnostics Corporation, Dexcom, Inc., Insulet Corporation, AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Johnson & Johnson Diabetes Institute, LLC. W.V. Tamborlane: Consultant; Self; AstraZeneca, Boehringer Ingelheim GmbH, Eli Lilly and Company, Medtronic MiniMed, Inc., Novo Nordisk Inc., Sanofi, Takeda Pharmaceuticals U.S.A., Inc.. M.A. Van Name: None. N. Bansal: None. C. Kollman: Research Support; Self; JDRF, Bigfoot Biomedical, Dexcom, Inc., Tandem Diabetes Care, Inc., Medtronic MiniMed, Inc., Helmsley Charitable Trust. R.L. Gal: Research Support; Self; Boehringer Ingelheim Pharmaceuticals, Inc., Takeda Development Center Americas, Inc., Novo Nordisk Inc..