The Effect Of Glycemic Control On Serum Lipids And Calcium – Phosphate Profiles In Patients With Type 2 Diabetes Mellitus

Abstract

The present study was carried out to investigate the effect of glycemic
control levels in type 2 diabetic patients on the serum lipids and
lipoprotein profiles and the serum levels of calcium, phosphate and
some other electrolytes.
The study was conducted on 81 patients with type 2 diabetes mellitus,
who were attending the Outpatient Diabetic and Endocrine Clinic in
King Khaled Hospital, Hail, Kingdom of Saudi Arabia. The patients
were classified into two groups depending on their glycosylated
hemoglobin (HbA1c); First: those with good glycemic control (GGC)
who had their HbA1c ≤ 7.5% (n= 38) and those with poor glycemic
control (PGC) who had their HbA1c > 7.5% (n= 43). The control
group comprised of 52 healthy subjects. All anthropometric and
biochemical measurements were carried out using the standard
methods.
Both control and diabetic groups showed high prevalence of obesity
with BMI values > 30 (32.2% of C, 34.2% of GGC and 39.5% of the
PGC). The fasting serum glucose levels in GGC and PGC groups were
significantly higher than control by 77.3% and 1.1-fold, respectively.
The serum total cholesterol (Tc) in the PGC group showed a
significant increase (P< 0.01) by 14.4%, whereas, the GGC was not
significantly different from control. Tc showed a significant positive
correlation with Hb A1c (r= 0.91, P=0.00007). On the other hand, the serum triglyceride was significantly higher (P< 0.01) in both GGC and
PGC groups. The VLDL was elevated in the GGC by 96.5% and in
the PGC by 100% compared to control, whereas, the LDLc fractions
in the GGC and PGC were increased by 9.1% and 16.7%,
respectively, but HDL-c was not altered. The Serum magnesium and
sodium levels were not altered in any of the diabetic groups. However,
calcium was significantly raised (P<0.05) in the PGC compared to
control, but not significantly different in GGC. Serum phosphate in
the GGC and PGC exhibited significant increases (P<0.001) and
(P<0.01), respectively. Similarly, the potassium levels were
significantly higher in both groups compared to control.
The type 2 diabetic patients who had better glycemic control showed
favorable lipid and lipoprotein profiles with lower risk factors for
atherosclerosis and had moderate calcium and phosphate levels
compared to their poorly controlled counterparts.

Key words: Glycemic control - type 2 diabetes mellitus-dyslipidemiacalcium-phosphate metabolism.