Factors affecting diabetes control and dyslipidaemia among type 2 diabetes mellitus patients in Hospital Universiti Sains Lviala Ysia
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Date
2003-01
Authors
Akhtar Mohammad, Eid Mohammad (Dr.)
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Abstract
This cross-sectional study was undertaken on 211 type 2 diabetic patients at the
Outpatients Diabetes Clinic, HUSM Kubang Kerian, Kelantan between the year 2001 -
2002. The study was conducted to determine whether the clinical targets for the control
of diabetes can be met in the context of routine endocrinology practice, and also to.
define the prevalence of dyslipidaemia, its correlation with glycaemic control and
contributing factors. Patients' medical history as well as their family history were
obtained using data collection form and physical examination was performed. Samples
of patients' venous blood during fasting were taken and analysed for plasma glucose,
glycated haemoglobin and lipid profile.
Of the total 211 patients, only 4.3 % were on diet, 3 7 % of them were on mono
therapy while 58.8% were on combination of therapies. There were 46 % patients on
lipid-lowering therapy and 54 % on antihypertensive therapy. Analysis showed that
many .Patients had comorbidities or complications. A large number of them had poor
glycaemic control (72.5 %). Systolic and diastolic blood pressures of 75.4 % and 84.8
% subjects were 2: 130 and 2: 80 mmHg, respectively. BMI values of 66.4 % of the
patients were outside the clinical target (BMI 2: 25 in male and 2: 24 kglm2 in female).
The iipid profile showed that 96.2 % patients had at least one lipid value outside clinical
target level. In this study, 70.14% of the patients had total cholesterol2: 5.2 mmoi!L,
87.2 % had LDL cholesterol 2: 2.6 mmol!L, 57.4 % had HDL cholesterol less than the
normal range, .S 1.15 mmoi/L in men and .S 1.4 mmoi/L in women. while 45.5 % had
triglycerides :;:: I. 71 mmoi/L. The most common dyslipidaemic patterns were mixed
hyperlipidaemia (36.8 %), followed by hypercholesterolaemia (34.2%) and
hypertriglyceridaemia (5.3 %). Complications of diabetes were observed in 47.9 % of
the total number of patients.
There were three variables that had significant effects on glycaemic control and
they are ethnicity, age and duration of diabetes. Younger Malay subjects ( < 50 years
old) had significantly the highest mean percent A 1 C. Patients who were recently
diagnosed (duration of diabetes < 5 years) had the best glycaemic control. Variables
that had significant effects on BMI were age, duration of diabetes, glycaemic control _
and gender. Young female and newly diagnosed subjects with good glycaemic control
(A 1 C < 7 %) were found to have higher BMI values. As for the patients' systolic blood
pressure, only two factors, namely age and duration diabetes, were found to have
significant effects. Aged subjects with a long duration of diabetes were more
hypertensive. Based on the study conducted, results showed that glycaemic control and
ethnicity were significantly important determinants of elevated total cholesterol, LDL
cholesterol and triglycerides levels. Gender and BMI were identified to be significantly
,.,.,
important determinants of elevated total cholesterol and triglycerides, respectively.
The overall clinical targets were suboptimal. The prevalence of hyperlipidaemia
was high, particularly hypercholesterolaemia. It is imperative that better treatment
strategies and methods be adopted to enhance diabetes control and reduce long-term
complications ofthe disease.
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Keywords
Diabetes control , Dyslipidaemia among type , Diabetes mellitus patients