Diabetic Dyslipidemia Among Diabetic Patients Attending Specialized Clinics in Dar es Salaam.

Abstract

Background: Diabetes mellitus is a major healthcare problem globally, and by 2030 there will be approximately 360 million patients world – over. Diabetes mellitus is associated with dyslipidemia involving quantitative and qualitative changes in lipoproteins. Correcting lipid abnormalities reduces the risks of coronary heart diseases (CHD) among diabetics. The prevalence of diabetic dyslipidemia and its association with glycemic control are all largely undetermined in Dar es Salaam. Objective: to determine the prevalence of diabetic dyslipidemia and its association with glycemic control among diabetes mellitus patients in Dar es Salaam. Methodology: A descriptive cross – sectional study was conducted between November 2006 and January 2007. Diabetic patients aged 18 years and above were recruited by simple random sampling technique from diabetic clinics in the city of Dar es Salaam. After enrolment each subject was interviewed using a structured questionnaire before undergoing a full physical examination. Fasting lipid profiles and glycosylated hemoglobin were measured using Konelab TM (© 2003 Thermo Electron Corporation) machine. Chi – squared test, Student\'s t – test and multiple logistic regression were used for data analysis. A p – value of < 0.05 was taken to represent a statistically significant difference between variables. Results: The prevalence of dyslipidemia was 95%. The commonest lipid derangement was hypertriglyceridemia with serum triglyceride level ranging from 1.00 – 3.26 mmol/L (mean 2.22 + 0.69). Dyslipidemia was mostly asymptomatic with only few presenting with angina, peripheral vascular disease and corneal arcus. In a multivariate analysis, poor glycemic control as determined by measurement of glycosylated hemoglobin was independently associated with dyslipidemia.
Conclusion and Recommendation: The prevalence of dyslipidemia among diabetes mellitus patients attending diabetic clinics in government hospitals in Dar es Salaam is alarmingly high. Since risk factors for heart diseases among diabetics are known to be additive and even multiplicative, mild degrees of dyslipidemia may increase CHD risk. Controlling dyslipidemia should be given equal emphasis as controlling hyperglycemia in managing diabetes mellitus.

Tanzania Medical Journal Vol. 23 (1) 2008: pp. 8-11