Abstract
Diabetes mellitus (DM) is a common endocrine metabolic disorder and a leading cause of death worldwide. Dyslipidemia is a well-recognized manifestation of uncontrolled DM, because insulin has important regulatory effects on lipid metabolism. This study was conducted to determine the frequency and pattern of dyslipidaemia in diabetic patients. Cross-sectional study was conducted on a total of two hundred ninety five diabetic patients attending diabetic follow-up clinic of Hawassa University Referral Hospital from March to November, 2014. For each selected subject, structured questionnaire about socio-demographic characteristics and diabetic related information was filled; overnight fasting blood samples were analyzed for fasting blood sugar (FBS) and lipid profiles, namely, total cholesterol (TC), triglyceride (TG), high density lipoprotein (HDL) and low density lipoprotein (LDL). Dyslipidemia was assessed according to the United State National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP-III) model guideline. SPSS version 20 was used as tool for data analysis. P-value of <0.05 was used as statistical significance. The mean (± standard deviation, SD) values of TC, TG, HDL, LDL were 186.03 (± 37.40), 194.33 (± 93.38), 49.66 (± 10.34), 119.15 (± 42.33) mg/dl, respectively. Among all of the diabetic patients, 34.9% had high serum LDL, 34.6% had hypercholesterolemia, 29.8% had hypertriglyceridemia and 12.2% had low HDL. Significantly higher mean serum levels of TC (p = 0.002) and LDL (p = 0.008) were noted in type 2 DM than type 1 DM. Females had significantly higher TC and LDL levels than males; whereas males had significantly lower HDL levels as compared to females (48.04 ± 9.13 versus 51.93 ± 11.49 mg/dl; p < 0.001). The mean (± SD) FBS level was 178.18(± 85.39) mg/dl and patients with type 1 DM had significantly higher FBS than those with type 2 DM (p < 0.001). Our study showed the presence of dyslipidaemia in Ethiopians with DM. The most common dyslipidemia in this study was high level of serum LDL followed by hypercholesterolemia and hypertriglyceridemia. The optimal care for diabetic patients should also include routine monitoring of serum lipid profile. Key words: Diabetes, lipid profile, dyslipidemia.
Highlights
Diabetes mellitus (DM) is a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action or both
In type 2 diabetes mellitus (T2DM), the most common abnormal lipid pattern is a combination of elevated TG levels and decreased high density lipoprotein (HDL) cholesterol (Dunn, 1990); whereas the dyslipidemia seen in poorly controlled type 1 diabetes mellitus (T1DM) is mainly due to accumulation of chylomicrons and very low density lipoproteins in the plasma (Chase and Glasgow, 1976; Bagdade et al, 1967)
For serum lipid reference level the NCEPATP III guideline (NCEP, 2002) was referred and in accordance with this guideline: hypercholesterolemia and hypertriglyceridemia were defined as total cholesterol (TC) ≥ 200 mg/dl and TG ≥ 150mg/dl, respectively; while high level of low density lipoprotein (LDL) was defined as LDL ≥ 130 mg/dl and low level of HDL was defined as HDL < 40 mg/dl
Summary
Diabetes mellitus (DM) is a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action or both. In type 2 diabetes mellitus (T2DM), the most common abnormal lipid pattern is a combination of elevated TG levels and decreased HDL cholesterol (Dunn, 1990); whereas the dyslipidemia seen in poorly controlled type 1 diabetes mellitus (T1DM) is mainly due to accumulation of chylomicrons and very low density lipoproteins in the plasma (Chase and Glasgow, 1976; Bagdade et al, 1967). In both groups of DM, normalization of glycemic control is followed by improvement or normalization of the dyslipidemias (Weidman et al, 1982). Abnormal serum lipids are likely to contribute to the risk of coronary artery disease in diabetic patients (Miller, 1999) and the determination of the serum lipid levels in people with diabetes is considered as a standard of the diabetes care (ADA, 1999)
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