effect of glycemic control on serum lipids and calcium - phosphate profiles in patients with type 2 diabetes mellitus

The present study was carried out to investigate the effect of glycemic control levels in type 2 diabetic patients on the serum lipids and lipoprotein profiles and the serum levels of calcium, phosphate and some other electrolytes. The study was conducted on 81 patients with type 2 diabetes mellitus, who were attending the Outpatient Diabetic and Endocrine Clinic in King Khaled Hospital, Hail, Kingdom of Saudi Arabia. The patients were classified into two groups depending on their glycosylated hemoglobin [HbAi]; First: those with good glycemic control [GGC] who had their HbAic 7.5% [n = 43]. The control group comprised of 52 healthy subjects. All anthropometric and biochemical measurements were carried out using the standard methods. Both control and diabetic groups showed high prevalence of obesity with BMI values > 30 [32.2% of C, 34.2% of GGC and 39.5% of the PGC]. The fasting serum glucose levels in GGC and PGC groups were significantly higher than control by 77.3% and 1.1-fold, respectively. The serum total cholesterol [Tc] in the PGC group showed a significant increase [P < 0.01] by 14.4%, whereas, the GGC was not significantly different from control. Tc showed a significant positive correlation with Hb Ale [r = 0.91, P = 0.00007]. On the other hand, the serum triglyceride was significantly higher [P < 0.01] in both GGC and PGC groups. The VLDL was elevated in the GGC by 96.5% and in the PGC by 100% compared to control, whereas, the LDLc fractions in the GGC and PGC were increased by 9.1% and 16.7%, respectively, but HDL-c was not-altered. The-Serunrrrragnesium and sodium levels were not altered in any of the diabetic groups. However, calcium was significantly raised [P0.05] in the PGC compared to control, but not significantly different in GGC. Serum phosphate in the GGC and PGC exhibited significant increases [P0.001] and [P0.01], respectively. Similarly, the potassium levels were significantly higher in both groups compared to control. The type 2 diabetic patients who had better glycemic control showed favorable lipid and lipoprotein profiles with lower risk factors for atherosclerosis and had moderate calcium and phosphate levels compared to their poorly controlled counterparts

effect of glycemic control in type 2 diabetic patients with diabetes-related dyslipidemia

The study was planned to investigate whether the serum lipid profile in type 2 diabetes mellitus was different between groups of patients classified as having good, satisfactory or poor glycemic controls, depending on their serum fructosamine levels. The study was carried out in the Department of Laboratory, Dammam College for Health Sciences, Dammam, Kingdom of Saudi Arabia between February 2003 to June 2003. Clinical laboratory data from diagnosed type 2 diabetic patients were used in the study. One hundred and nineteen patient's data were randomly selected, and according to their serum fructosamine levels, the patients were divided into 3 groups: 29 patients classified as patients with good glycemic control [GGC] with serum fructosamine level <250 umol/L, 44 patients classified as satisfactory glycemic control [SGC] with serum fructosamine level ranging between 250-355 umol/L and 46 patients classified as poor glycemic control [PGC] with serum fructosamine >355 umol/L. The fasting serum glucose and various lipids and lipoprotein concentrations of each group were analyzed by one way analysis of variance and regression analysis. In the PGC group, the serum total cholesterol [6.11 +/- 1.56 mmol/l], triglyceride [2.13 +/- 0.71 mmol/L] and very low density lipoprotein-cholesterol [1.09 +/- 0.40 mmol/L] concentrations were significantly higher than that of the SGC [5.59 +/- 0.89, 1.59 +/- 0.38 and 0.86 +/- 0.28 mmol/L,], and the GGC [5.11 +/- 1.06, 1.25 +/- 0.32 and 0.78 +/- 0.29 mmol/L], whereas, those of the SGC were slightly raised, but not statistically significant, compared to the GGC. The high density lipoprotein cholesterol was significantly lower, and the low density lipoprotein cholesterol was elevated in both satisfactory and poorly controlled groups compared to good control group. Significant correlations were evident between the serum fructosamine and glucose concentrations [r=0.79, p<0.0001], and between them as independent parameters and the serum lipid concentrations. The glycemic control in type 2 diabetes significantly improves diabetic related dyslipidemia, and would be expected to reduce the risk of atherosclerosis. It is also worth mentioning that the serum fructosamine measure gives a good index for the glycemic control, and its value can reflect the profile of serum lipids