ABSTRACT
Diabetes is characterized by chronic hyperglycemia and disturbances of carbohydrate, lipid and protein metabolism. We aimed to estimate the cardiovascular risk factors and their correlation with type 2 diabetes mellitus (T2DM) in Zanzibar (Mnazi MMoja Hospital) hypothesizing that early detection and treatment of lipid abnormalities can minimize the risk for atherogenic cardiovascular disorders and cerebrovascular accident in patients with T2DM. Methods: The study populations were those patients who presented themselves at Mnazi Mmoja hospital with T2DM, and who are within the age bracket of 18 to 45 years. Fasting blood glucose (FBG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), and triglyceride (TG) levels were evaluated. Pearson’s correlation studies were performed between the variables of blood glucose and serum lipid profiles and also within the lipid profile parameters Results: TC, TG, LDL-C mean levels were significantly higher in diabetics compared with the control subjects p< 0.05. The HDL-C was however lower in diabetics compared with the controls. Also, the mean FBG, TC, TG, and LDL-C were significantly higher in female diabetic subjects compared to the male counterparts p< 0.05. A positive correlation was observed between FBG and TC, TG and LDL-C (r=0.643 p=0.0021; r=0.679, p=0.0001; r=0.534, p=0.0091 respectively) while HDL-C showed a negative correlation (r= -0.799, p= 0.0021). TC also showed a positive correlation with TG and LDL-C (r=0.590, p=0.0021; r= 0.628, p=0.0001) and negative correlation with HDL-C ( r=-0.670, p=0.0041). Conclusion: There is an influence of gender on cardiovascular disease risk factors with more of the females seriously at risk. Measurement of serum lipid profile should be introduced to the management plan of diabetes mellitus. There is an urgent need for the establishment of regional and national training courses for diabetic educators and also the creation of new evidence-based management plan for diabetics in Zanzibar for a better healthcare.
ABSTRACT
Diabetes mellitus has been associated with increased risk of oxidative stress. There is limited information on the significance of an early marker of oxidative stress which can reflect the total antioxidative activity, especially in poorly controlled diabetes mellitus. The aim of this study was to establish association of glycaemic control determinants and total antioxidant activity and also to evaluate the frequency of occurrence of reduced antioxidant activity in poorly controlled glycaemia. This was a cross sectional study carried over three months. The study population consisted of two hundred type 2 diabetes mellitus patients attending the diabetic clinics of Lagos State University Teaching Hospital, Ikeja and General Hospital, Gbagada. These categories of patients were males and females between the ages of 40 and 60 years. Glycaemic control was assessed using fasting plasma glucose, fructosamine and glycosylated haemoglobin. Biochemical parameters were compared using students't test, Pearson's correlation coefficient and analysis of variance. This study demonstrated reduced total antioxidant activity in Nigerian diabetics in comparison with control subjects [p < 0.05] and was observed to be much lower in complicated diabetes mellitus patients. Consistent negative association of total antioxidant activity with short, medium and long term glycaemic control determinants fasting plasma glucos "r = -0.43, p = 0.001", fructosamine "r = -0.42, p = 0.002" and glycosylated haemoglobin "r = - 0.35, p = 0.030" was observed. The clinical usefulness of total antioxidant activity as a surrogate marker of glycaemic control is shown. This may be useful in the early detection of diabetic complications. Significant reduction of total antioxidant activity especially among diabetics with complications suggests a possible role of this in the pathogenesis of diabetic complications