Adequacy of glycemic control and serum lipid profile in hemodialysis of Palestinian patients with diabetes mellitus

ABSTRACT

Inadequate glycemic control and lipid abnormalities which are prevalent among diabetic patients on hemodialysis may act synergistically to place these patients at an augmented risk for morbidity and mortality of diabetic complications. The purpose of this case-controlled study was to assess the glycemic control and prevalence of dyslipidemia among diabetics who were on hemodialysis, by following them up for ten months and carrying out the following measurements, glycated hemoglobin A[1c], LDL, HDL, total cholesterol, and triglycerides, over the time of study, from Nov 2007 to Aug 2008. Fifteen patients died during the study period, ten of them had history of hypertension before reaching the chronic renal failure. The results showed a significant elevation in A[IC]% among the patients in comparison to healthy controls. More than 40% of patients were with inadequate glycemic control [A[IC] >6.5%]. More than half [55.6%] of patients who underwent insulin therapy were with inadequate glycemic control. Dyslipidemia was characteristic in patients, where the levels of HDL-C were found to be significantly lower in all patients compared to controls 32.5 +/- 8.8 vs. 42.7 +/- 9.1 mg/dl; respectively. The mean HDL/LDLratio in patients was higher than in controls, 3.6 +/- 1.3 vs. 2.7 +/- 0.8; respectively. Inadequate glycemic control in diabetics on hemodialysis was prevalent, insulin resistance is suggested, dyslipidemia is predominate, and further follow up of these patients is recommended