Prevalence and pattern of dyslipidaemia in type 2 diabetes mellitus patients at a tertiary care hospital

Abstract

Background: Diabetes mellitus (DM) is a common secondary cause of dyslipidaemia, particularly if glycaemic control is poor, which in turn is an important risk factor for atherosclerosis and coronary artery disease.
Objectives: (1) To study the prevalence and pattern of dyslipidaemia in patients with type 2 DM. (2) To determine the relationship (if any) between HbA1C and the lipid profile in type 2 diabetic patients.
Methods: This was a cross-sectional study done in 200 type 2 diabetic patients  attending the Diabetic Clinic at the Helen Joseph Hospital. Patients suffering from other known causes of secondary dyslipidaemia were excluded. Each patient’s  HbA1C and lipid profile results were recorded from their clinic files. The lipid profile included total cholesterol (TC), triglyceride (TG), high-density lipoprotein  cholesterol (HDL-C) and calculated low-density lipoprotein cholesterol (LDL-C). Patients with one or more of the above parameters outside the targets recommended by the 2012 South African Dyslipidaemia Guidelines were considered to have uncontrolled dyslipidaemia.
Results: Of the 200 type 2 DM patients studied, 86 (43%) were male and 114 (57%) female. Despite all patients being treated with lipid-lowering therapy  (simvastatin at a mean daily dose of 20 mg), 187 patients (93.5%) did not achieve all their lipid targets. The most prevalent lipid parameter not at target was an LDL-C of ≥ 1.8 mmol/l in nearly 80% of patients. The most common pattern of  dyslipidaemia was a combined dyslipidaemia (any two abnormal lipid parameters) affecting a total of 82 out of the 187 patients (43.8%) not reaching recommended  targets. No significant relationship was found between HbA1C and any of the lipid parameters.
Conclusion: The vast majority of the type 2 diabetic patients studied had  dyslipidaemia not meeting recommended targets, despite the use of lipid-lowering therapy in all patients. There is a need for more intensive lipid-lowering therapy, particularly statin therapy in patients with dyslipidaemia. Measures aimed at  combating obesity and other lifestyle-related risk factors are also vital and need to be implemented for effectively controlling dyslipidaemia and reducing the burden of CVD.

Keywords: combined dyslipidaemia, LDL, lipid targets