RESUMO
The nature of the dyslipidemia associated with diabetes mellitus is complex and is the major risk factor for atherosclerosis and coronary artery disease. Aim of this study was to assess the effect of glycemic control, achieved by metformin, glibenclamide and insulin, on lipid profile in type 2 diabetic patients. One hundred and sixty-five type 2 diabetes mellitus patients were classified into good glycemic control (Group I) and poor glycemic control (Group II) on the basis of their blood HbA1c values. The Group II was characterized with high serum triglyceride (190.46 ± 15.20 mg/dl), total cholesterol (175.3 ± 6.31 mg/dl) as well as high LDL-cholesterol (109.0 ± 5.88 mg/dl). Significant correlations were evident between HbA1c and dyslipidemia, particularly serum TG (r = 0.28, P < 0.05), and between HbA1c and total cholesterol (r = 0.310, P < 0.05). Better glycemic control and improved dyslipidemia were observed in patients on combination therapy of metformin plus glibenclamide.
RESUMO
Serum lipids and lipoproteins were determined in 302 randomly selected diabetic patients attending the Tikur Anbessa Hospital diabetic clinic. The main objective of the study was to analyse lipid levels in type 1 and type 2 diabetic patients. Lipid measurement was done by cholesterol pap method. The mean age was 41.4 +/- 14.4 years (range 14-85 years). One hundred sixty (53%) were males and 142 (47%) were females. There were 140 (46.4%) type 1 and 162 (53.6%) type 2 patients. The mean duration of diabetes mellitus, haemoglobin A1c, fasting blood glucose and random blood glucose were 9.4 +/- 5.4 years, 10.4 +/- 2.2%, 195.5 +/- 79.9 mg/dl and 273.1 +/- 114.5 mg/dl respectively. The mean cholesterol, triglycerides, LDL, VLDL and HDL were 166.5 +/- 45.5 mg/dl, 129.9 +/- 92.4 mg/dl, 94.5 +/- 36.4 mg/dl, 24.4 +/- 15.1 mg/dl and 44.3 +/- 11.5 mg/dl respectively. Hypercholesterolemia and Hypertriglyceridemia were seen in 18.5% and 14.2% of the patients. Total cholesterol was significantly higher in females than in males and in type 2 than in type 1 patients (179.3 +/- 48.4 mg/dl versus 154.1 +/- 38.2 mg/dl, P < 0.01 and 183.2 +/- 43.7 mg/dl versus 145.9 +/- 37.6 mg/dl, P < 0.001) respectively. Triglycerides and LDL cholesterol were also significantly higher in type 2 diabetic patients than in type 1 diabetic patients (162.7 +/- 10.5 mg/dl versus 91.5 +/- 53.3 mg/dl, P < 0.001 and 105.6 +/- 36.2 mg/dl versus 81.9 +/- 32.2 mg/dl, P < 0.001), but HDL cholesterol was the same in both types of diabetic patients. Similarly, hyperlipidemia was associated with obesity and hypertension. The study confirms that lipid values are high particularly in type 2 diabetic patients. Hence our patients are at increased risk of developing atherosclerosis therefore periodic check up of lipids in diabetic patients and effective treatment of the dyslipidemia along with a tight metabolic control was recommended.
