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International Journal of Clinical Biochemistry and Research


Role of Glycemic control and Lipid profiles in management of Diabetic complications


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Author Details: Dipti Basavraj Sanakal, Sagar Chandrakant Mhetre, Shailaja Katti

Volume : 3

Issue : 2

Online ISSN : 2394-6377

Print ISSN : 2394-6369

Article First Page : 208

Article End Page : 213


Abstract

Background & objectives: Diabetes mellitus is one of the most common endocrine disorders affecting about 6% of the world’s population. Diabetes mellitus is the leading cause of end stage renal disease (ESRD), a major cause of non-traumatic amputations, responsible for preventable blindness and a leading cause of cardiovascular mortality.
Hyperglycemia and dyslipidemia play an important role in the development of microvascular and macrovascular complications, leading to significant impact on the quality of life. 
The objective of the study was to assess the glycemic control by estimation of glycosylated hemoglobin (HbA1c), and lipid profile in patients of Diabetes mellitus without complications and in Diabetes mellitus with complications like neuropathy, retinopathy and nephropathy and compare with controls.
Methods: The present study comprised of 100 clinically diagnosed and confirmed cases of type 2 Diabetes mellitus attending and admitted in Navodaya Medical College Hospital and Research centre, Raichur.
The subjects were grouped as follows
Age and Sex matched controls - 25
Group A. Diabetes mellitus without complications - 25
Group B. Diabetes mellitus with retinopathy - 25
Group C. Diabetes mellitus with nephropathy - 25
Group D. Diabetes mellitus with peripheral neuropathy - 25
Glycosylated hemoglobin (HbA1c), Total Cholesterol, Triglycerides and HDL-Cholesterol were estimated in all groups. LDL-Cholesterol and VLDL-Cholesterol were calculated in all groups by using Friedewald’s formula.
Results: Our study showed that HbA1c levels were significantly higher (p<0.01) in all groups of patients as compared to controls. The increase in Serum Cholesterol, Triglyceride, LDL-Cholesterol, VLDL-Cholesterol and decrease in HDL-Cholesterol levels were statistically significant (p<0.01) in Diabetic retinopathy group and Diabetic nephropathy group as compared to controls, whereas in Diabetic neuropathy group and in Diabetes mellitus without complication, the increase in Serum Cholesterol, Triglyceride, LDL-Cholesterol, VLDL-Cholesterol and decrease in HDL-Cholesterol levels was not statistically significant as compared to controls.
Conclusion: Impaired insulin secretion or insulin resistance impairs glucose utilization by the insulin sensitive tissue which in turn increases hepatic output of glucose, contributing to hyperglycemia. Hyperglycemia leads to diverse cellular and organ dysfunction. Dyslipidemia acts synergistically with hyperglycemia in the development of Diabetes mellitus associated complications.
Our study revealed that poor glycemic control and dyslipidemia are associated with Diabetic complications like neuropathy, retinopathy and nephropathy. Estimation of glycosylated hemoglobin and lipid profile helps in predicting the development of microvascular complications. Therefore intensive glycemic control and aggressive treatment of dyslipidemia can help in reducing Diabetes mellitus associated complications.

Key words:
Hyperglycemia; glycosylated hemoglobin; dyslipidemia; end stage renal disease (ESRD); retinopathy; lipid profile; neuropathy.