The effect of glycemic control in type 2 diabetic patients with diabetes-related dyslipidemia

OBJECTIVE: The study was planned to investigate whether the serum lipid profile in type 2 diabetes mellitus was different between groups of patients classified as having good, satisfactory or poor glycemic controls, depending on their serum fructosamine levels.

METHODS: The study was carried out in the Department of Laboratory, Dammam College for Health Sciences, Dammam, Kingdom of Saudi Arabia between February 2003 to June 2003. Clinical laboratory data from diagnosed type 2 diabetic patients were used in the study. One hundred and nineteen patient's data were randomly selected, and according to their serum fructosamine levels, the patients were divided into 3 groups: 29 patients classified as patients with good glycemic control (GGC) with serum fructosamine level <250 umol/L, 44 patients classified as satisfactory glycemic control (SGC) with serum fructosamine level ranging between 250-355 umol/L and 46 patients classified as poor glycemic control (PGC) with serum fructosamine >355 umol/L. The fasting serum glucose and various lipids and lipoprotein concentrations of each group were analyzed by one way analysis of variance and regression analysis.

RESULTS: In the PGC group, the serum total cholesterol (6.11+/- 1.56 mmol/l), triglyceride (2.13 +/- 0.71 mmol/L) and very low density lipoprotein-cholesterol (1.09 +/- 0.40 mmol/L) concentrations were significantly higher than that of the SGC (5.59 +/- 0.89, 1.59 +/- 0.38 and 0.86 +/- 0.28 mmol/L,), and the GGC (5.11 +/- 1.06, 1.25 +/- 0.32 and 0.78 +/- 0.29 mmol/L), whereas, those of the SGC were slightly raised, but not statistically significant, compared to the GGC. The high density lipoprotein cholesterol was significantly lower, and the low density lipoprotein cholesterol was elevated in both satisfactory and poorly controlled groups compared to good control group. Significant correlations were evident between the serum fructosamine and glucose concentrations (r=0.79, p<0.0001), and between them as independent parameters and the serum lipid concentrations.

CONCLUSION: The glycemic control in type 2 diabetes significantly improves diabetic related dyslipidemia, and would be expected to reduce the risk of atherosclerosis. It is also worth mentioning that the serum fructosamine measure gives a good index for the glycemic control, and its value can reflect the profile of serum lipids.