Type 1 diabetes mellitus, familial hypercholesterolemia, and elevated lipoprotein (a).

Risk factor screening of all youth, including those with high-risk medical conditions such as diabetes mellitus, is important to reduce premature morbidity and mortality attributable to atherosclerotic cardiovascular disease. In those found to have significant hypercholesterolemia and/or elevated levels of lipoprotein (a), reverse cascade screening (child to parent) is recommended. This case demonstrates the benefits of targeted lipid testing. Early detection may provide additional motivation for families to adopt healthier lifestyles and reduce future atherosclerotic cardiovascular disease events in the child, siblings, and parents.