INTRODUCTION:

Diabetes mellitus is a group of metabolic disorder caused due to insulin resistance or insulin deficiency which increases blood sugar levels in the blood¹. Diabetes ranked 7th among leading cause of death². The prevalence of type 2 diabetes is more in developing countries that are 2/3 of diabetic patient living in developing countries³. At present the countries with largest numbers of diabetic patients are India, China and United states.

The major cause of hospital admission of diabetes patients are due to acute and chronic complications⁴. If preventive measure are not taken it is estimated that 438 million people have diabetes by 2030⁵. Diabetes Federation states that the number of diabetes patients in India is doubled from 19 million in 1995 to 40.9 million 2007 and said to increase to 69.9 million by 2025⁶. The dyslipidaemias are commonly seen in diabetes patients which cause greater risk of cardiovascular disease⁷.The prevalence of dyslipidaemia is 95% in diabetic patients⁸. The lipid abnormalities commonly present in type 2 diabetes include an abnormally high level of TG, HDL, LDL, and postprandial lipemia. This pattern of lipid profile in diabetes is termed as diabetic dyslipidaemia^9,10,11. In uncontrolled type 2 diabetes, TC, VLDL and TGL are raised due to both at fasting and mixed meal, which can leads to a greater risk of morbidity and mortality of cardiovascular disease¹². The increase in cholesterol are the major factor for creating atherosclerosis in artery wall and 50% of diabetic patient die due to cardiovascular disease like heart disease and stroke^13,14,15. The treatment of dyslipidaemias is to decrease LDL levels which are achieved by lipid lowering drugs, physical exercise, lifestyle changes and modifications of diet¹⁶. Diabetes is the most common cause of kidney failure, even when diabetes is under control, the disease can lead to kidney failure and chronic kidney disease¹⁷. In chronic renal failure patients, diabetic nephropathy was estimated about 30.3 %¹⁸.Blood tests for creatinine and blood urea nitrogen (BUN) are the common way to monitor renal function¹⁹. Hence we carried out a retrospective study to determine the significance of assessment of lipid profile and renal function in type 2 diabetic patients. Routine monitoring of lipid profile and sugar levels can help to control or avoid further cardiovascular and renal complications.

MATERIALS AND METHODS:

This retrospective observational study was conducted in the general medicine department of a tertiary teaching care hospital. A total of 70 patients with history of type 2 diabetes were taken as subject for the study. The study period was about three months. The demographic details and laboratory parameters of 70 patients were collected from the case records. Patients aged above 18 years of both genders with type 2 diabetes more than 5 years were included in the study. The patients with other comorbidities such as stroke, myocardial infarction and peptic ulcer were excluded from the study. Patient’s blood sugar levels, lipid profile and renal parameters were analysed. The values of FBS, PPBS, lipid profile and renal function were expressed as the mean and standard deviation values. The level of significance was determined by student t test using graph pad prism method.

RESULTS:

Out of 70 diabetic cases 39 (56%) were males and 31(44%) females. The patient age ranged from 23 to 80 years. The mean age of male and female patients were 50±14.25 and 51.06±14.61 years, respectively. The average age group of the study population was found to be 50.47±14.32 years as shown in Table 1. Blood glucose levels of diabetic patients of our present study were depicted in Table 2.

Table 1: The Gender wise Distribution of the Diabetic patients

Gender	Age in years	Total (n=70)	Percentage (%)
Male	50±14.25	39	56
Female	51.06±14.61	31	44

Table 2: Blood glucose levels in Diabetic patients

Parameters (mg/dl)	Gender (n = 70)		Mean ± SD changes
	Male (n=39)	Female (n=31)	Total (n=70)
FBS	146.74±52.74	178.96±90.69	161.01±73.26
PPBS	199.23 ±87.29	245.38±104.59	219.67±97.39

Table 3 and Table 4 show the lipid profile and prevalence of dyslipidemia in Type 2 diabetes mellitus patients, which are based on adult treatment panel (ATP III) classification, respectively.

Table 3: Lipid profile determination in Diabetes mellitus

Lipid profile (mg/dl)	Male (n=39)	Female (n=31)	Total (n=70)
TC	181.17±49.01	187.54±55.89	184±51.88
HDL	52.28±30.02	69.90±48.16	60.08±39.78
TGL	167.69±178.65	179.74±94.67	173.02±146.66
VLDL	27.64±22.04	33.54±15.58	30.25±19.54
LDL	104.87±45.21	95.41±53.04	100.68±48.69

Table 4: Prevalence of Dyslipidaemia in Type 2 Diabetes mellitus

Lipid (mg/dl)	Male	Female	Total of patients	Percentage (%)
TC>200	14	13	27	38
HDL < 40	18	9	27	38
TGL>150	10	17	27	38
LDL>100	26	19	45	64

Renal function parameters of our study population were shown in Table 5. Blood urea was slightly higher in females than males and serum creatinine was found to be similar between both the groups in the study population.

Table 5: Renal function in Type 2 Diabetes mellitus

Renal Parameters (mg/dl)	Male (n=39)	Female (n=31)	Total (n=70)
Blood urea	23.25±8.27	24.03±10.18	23.6±9.11
Serum creatinine	0.79±0.19	0.78±0.37	0.79±0.28

DISCUSSION:

The male patients were more (56%) when compared with female patients (44%) in concordance to the previous study¹⁶. In our study average age of diabetic patients of male patients was found to be 50±14.25 years and female patients was found to be 51.01±4.61years which is similar to the previous study by Singh et al²⁰. In our study FBS values of both males and females are quite similar to earlier reports²¹. Females have higher values of FBS, PPBS than males indicating that poor glycemic control in females which can lead to diabetic complications which is contrary to the earlier studies that showed males were prone to have higher values of FBS and PPBS^22,23. The strict glycemic control can prevent the risk of both microvacular and macrovascular complications. In our study it is observed that females were found to have slightly higher values of TC, HDL, and TGL than males, which is in concordance to the previous studies^12,
22-24. But LDL is higher in male diabetic patients. All these higher lipid profile values may lead to cardiovascular complications in both genders^24,
25. Blood urea and serum creatinine were found to be normal in both the genders of type 2 diabetes mellitus patients²⁶.

CONCLUSION:

In our study we have found that poor glycaemic control is in observed especially in females diabetics compared to males. The prevalence of dyslipidaemia was also seen in both genders of diabetic patients. Hence diabetic patients should be self-aware about routine monitoring of lipid profile and sugar levels so that they keep in control to avoid further cardiovascular complications. Physical exercise, life style changes, weight reduction with optimum treatment of anti-diabetic drugs and lipid lowering drugs with evidence- based necessary conditions and diet restriction to prevent micro and macro complications in diabetes patients.

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Received on 16.11.2017 Modified on 20.12.2017

Research J. Pharm. and Tech 2018; 11(4): 1624-1626.

DOI: 10.5958/0974-360X.2018.00302.5