Pediatric Patients with Type 1 Diabetes In a randomized, controlled clinical study (Study D), pediatric patients (age range 6 to 15 years) with type 1 diabetes (n = 349) were treated for 28 weeks with a basal-bolus insulin regimen where regular human insulin was used before each meal

Mechanism of Disease In cells missing the vital LAL enzyme, upregulation of cholesterol synthesis resulting from cellular dysfunction leads to ongoing lysosomal accumulation 1 LAL-D is characterized by Disrupted Cholesterol Metabolism and Intracellular Accumulation of Lipids Across Organ Systems 1,3 LAL-D LEADS TO PROGRESSIVE MULTISYSTEM ORGAN DAMAGE 2 LAL-D is characterized by disrupted cholesterol metabolism and intracellular accumulation of lipids across organ systems 2 Lipa Mutation 1 Missing or decreased LAL enzyme 1 Lysosomal accumulation of CE/TG 1 Dysregulated lipid metabolism 1 Liver 1,2 Hepatomegaly Hepatic injury ALT AST POSSIBLE/POTENTIAL CONSEQUENCes Microvesicular or mixed steatosis Fibrosis Cirrhosis Portal hypertension Liver failure HEART 1,2 Dyslipidemia LDL-C HDL-C POSSIBLE/POTENTIAL CONSEQUENCes Accelerated atherosclerosis Coronary artery disease Stroke Myocardial infarction Spleen 1,2,4 Splenomegaly POSSIBLE/POTENTIAL CONSEQUENCes Anemia Thrombocytopenia Risk of traumatic rupture and/or splenectomy Intestine 1,2 Intestinal lipid accumulation POSSIBLE/POTENTIAL CONSEQUENCes Abdominal pain Malabsorption Growth failure Abbreviations: ALT, alanine aminotransferase

Selected patients may be evaluated for phentermine, Qsymia, Contrave, diethylpropion, phendimetrazine, orlistat, topiramate or another appropriate option
Cardiovascular benefits: Numerous studies have demonstrated that GLP-1s reduce cardiovascular risk in patients with diabetes or those at high cardiovascular risk, independent of their HbA1c levels
Conversely, constipation may lead to hard stools, straining, and hemorrhoidal engorgement