Correlation between glycemic control and dyslipidemia in Type 2 Diabetes Mellitus patient
Keywords:Dyslipidemia, Glycemic control, HbA1C, Type 2 diabetes mellitus
Background: India is one of the countries with highest number of diabetes patients. Patients of type 2 diabetes mellitus are usually dyslipidemic. The objective of the research was to study the pattern of dyslipidemia and to study the correlation of glycemic control with dyslipidemia in type 2 diabetes mellitus patients.
Methods: A cross sectional observational study was performed on patients of type 2 diabetes mellitus over 6 months period. The study included 200 patients and the variables recorded were demographic profile, FBS, PPBS, HbA1C and lipid profile parameters. The patients were divided into 3 groups according to HbA1C level i.e. Group I (Good glycemic control HbA1C 6-7 gm%), group II (Fair glycemic control HbA1C 7.1-8.2 gm%) and group III (poor glycemic control, HbA1C >8.2 gm%).
Results: The data showed that TG level was maximum in group III and was minimum in group I. Comparison between the group shows a significant difference between all the groups (P <0.001). A significant positive correlation (Correlation coefficient 0.67, P <0.001) was also observed between level of TG and HbA1C. Similarly, LDL level was also highest in group III with a significant difference with other two groups (P <0.05). Also, a positive correlation (Correlation coefficient 0.64, P <0.05) was observed between LDL and HbA1C. On the other hand, HDL was lowest in group III as compared to groups I and II (P <0.001) and a negative correlation (Correlation coefficient -0.716, P <0.001) was seen between HDL and HbA1C.
Conclusions: Dyslipidemia is less prevalent in diabetics who have better glycemic control.
Maitra A, Abbas AK. Endocrine system. In: Kumar V, Fausto N, Abbas AK, eds. Robbins and Cotran Pathologic Basis of Disease. 7th ed. Philadelphia, Saunders; 2005:1156-226.
Dabelea D, Mayer-Davis EJ, Saydah S, Imperatore G, Linder B, Divers J, et al. Prevalence of type 1 and type 2 diabetes among children and adolescents from 2001 to 2009. JAMA. 2014;311:1778-86.
Rizvi A, Sanders MB. Assessment and monitoring of glycemic control in primary diabetes care: monitoring techniques, record keeping, meter downloads, tests of average glycemia, and point of- care evaluation. J Am Acad Nurse Pract. 2006;18:11-21.
Krauss RM. Lipids and lipoproteins in patients with type 2 diabetes. Diab Care. 2004;27:1496-504.
Haffner SM. American Diabetes Association Management of dyslipidemia in adults with diabetes. Diab Care. 2003;26(1):s83-6.
Daya R, Bayatand Z, Raal FJ. Prevalence and pattern of dyslipidaemia in type 2 diabetes mellitus patients at a tertiary care hospital. J Endocrinol Metab Diab South Africa. 2017;22:3:31-5.
Mandal M, Kumari R, Mukherjee A. Prevalence of dyslipidemia in patients with type 2 diabetes mellitus: a hospital based study in Kishanganj, India. Int J Res Med Sci. 2015;3:3691-7.
Schwartz SL. Diabetes and dyslipidaemia. Diab Obes Metab. 2006;8(4):355-64.
Mahmood K, Aamir AH. Glycemic control status in patients with type-2 diabetes. J Coll Physicians Surg Pak. 2005;15(6):323-5.
Diabetes Mellitus: Complications. In: DL Kasper, AS Fauci, DL Longo, SL Hauser, JL Jameson, J Loscalzo, eds. Harrison's Principles of Internal Medicine. New York: McGraw-Hill Education; 2015:2399.
Supriya, Mohanty S, Pinnelli VBK. Role of glycated hemoglobin (HBA1c) as a dual marker to predict glycemic status and dyslipidemia in Type 2 diabetes mellitus. Int J Res Med Sci. 2016;4:4524-9.
John LJ, Arifulla M, Sreedharan J, Muttappallymyalil J, Das R, John J, et al. Age and gender based utilization pattern of antidiabetic drugs in Ajman, UAE. Malaysian J Pharmaceut Sci. 2012;10(1):79-85.
Ramesh R, Kumar SV, Gopinath S, Gavaskar B, Gandhiji G. Diabetic knowledge of rural community and drug utilization pattern in a tertiary care hospital. Int J Pharm Life Sci. 2011;2(1):531-5.
Boccuzzi SJ, Wogen J, Fox J. Utilization of oral hypoglycemic agents in a drug-insured U.S. Population. Diab Care. 2004;24:1411-5.
Yurgin N, Secnik K, Lage MJ. Antidiabetic prescriptions and glycemic control in German patients with type 2 diabetes mellitus: a retrospective database study. Clin Ther. 2007;29:316-25.
Mandal S. Drug utilization study in patients with type 2 diabetes mellitus attending diabetes clinic of a tertiary care hospital in rural Bengal. Int J Basic Clin Pharmacol. 2016;5(4):1647-54.
Sharma A, Sharma P, Gaur A, Chhabra M, Kaur R. A cross-sectional study on diabetes mellitus type-2 at a tertiary care hospital. Adv Res Gastro Entero Hepatol; 2017; 8(1):1-6.
Bala M, Meenakshi, KM, Gupta A. Correlation of HbA1C levels with body mass index in newly diagnosed polycystic ovary syndrome. EJIFCC. 2017;28(3):196-204.
Babikr WG, Alshahrani ASA, Hamid HGM, Ahmed, Abdelraheem HMK, Shalayel MHF. The correlation of HbA1c with body mass index and HDL-cholesterol in type 2 diabetic patients. Biomedical Res. 2016;27(4):1280-3.
Expert Panel on Detection E. Executive summary of the third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). JAMA. 2001;285(19):2486.
Taliyan S, Nagtilak S, Parashar P, Rastogi A. Correlation between Glycated hemoglobin and Lipid profile in Type 2 Diabetic population of district Meerut, U.P. Int J Biomed Adv Res. 2016;7(11):534-6.
Khan HA, Sobki SH, Khan SA. Association between glycaemic control and serum lipid profile in type 2 diabetic patients: HbA1c predicts dyslipidemia. Clin Exp Med. 2007;7(1):24-9.
Wexler DJ, Grant RW, Meigs JB, Nathan DM, Cagliero E. Sex disparities in treatment of cardio risk factors in patient with type2 diabetes. Diab Care. 2005;28(3):514-20.
Faghihimani Z, Mirmiran P, Sohrab G, Iraj B, Faghihimani E. Effects of pomegranate seed oil on metabolic state of patients with type 2 diabetes mellitus. Int J Prev Med. 2016;7:124.
Chehade JM, Gladysz M, Mooradian AD. Dyslipidemia in type 2 diabetes: Prevalence, pathophysiology, and management. Drugs. 2013;73:327-39.
Nikkilä EA, Taskinen MR. Lipoprotein lipase of adipose tissue and skeletal muscle in human obesity: response to glucose and to semistarvation. Metabolism. 1981;30(8):810-7.
Kruit JK, Brunham LR, Verchere CB, Hayden MR. HDL and LDL cholesterol significantly influence beta-cell function in type 2 diabetes mellitus. Curr Opin Lipidol. 2010;21:178-85.
Pétremand J, Puyal J, Chatton JY, Duprez J, Allagnat F, Frias M, et al. HDLs protect pancreatic β-cells against ER stress by restoring protein folding and trafficking. Diab. 2012;61:1100-11.
Ray KK, Seshasai SR, Wijesuriya S. Effect of intensive control of glucose on cardiovascular outcomes and death in patients with diabetes mellitus: a meta-analysis of randomized controlled trials. Lancet. 2009;373:1765-72.
Khaw KT. Glycated haemoglobin, diabetes, and mortality in men in Norfolk cohort of European prospective investigation of cancer and nutrition. Brit Med J. 2001;332:15-8.