Abstract
Introduction. Diabetes mellitus (DM) is a group of metabolic diseases characterized by hyperglycemia due to insulin resistance, deficiency of insulin action, or both with a prevalence of 8.5% in Indonesia. Evidence regarding the relationship between HbA1c and lipid profile in type 2 DM is currently contradictory, therefore a study was conducted to examine the relationship between glycemic control and lipid profile for DM patients.Methods. This survey research was conducted at the outpatient endocrine clinic Dr. Saiful Anwar Malang Hospital in 2014-2019 with a total of 1,308 patients. Patients were then classified into type 2 DM patients with good (HbA1c < 7%, n = 291) and poor glycemic control (HbA1c > 7%, n = 1017).Results. There were lower levels of total cholesterol (183.9 (SD 38.7) mg/dl vs. 198.6 (SD 44.8) mg/dl; p < 0.001), triglycerides (144.2 (SD 67.5) mg/dl vs. 172.9 (SD 112) mg/dl; p < 0.001), and low-density lipoprotein (LDL-C) (119.2 (SD 32.1) mg/dl vs. 131 (SD 35.4) mg/dl; p < 0.001) in type 2 DM patients with good glycemic control compared to poor glycemic control group. There was no significant difference in high-density lipoprotein (HDL-C) levels between the two groups (47.7 (SD 13.4) mg/dl vs. 47.5 (SD 12.7) mg/dl; p = 0.89). There was a significant correlation between total cholesterol levels (r = 0.232; p < 0.001), triglycerides (r = 0.223; p < 0.001), and LDL-C (r = 0.20; p < 0.001) with HbA1c levels.173Jurnal Penyakit Dalam Indonesia | Vol. 8, No. 4 | Desember 2021|Perbandingan Profil Lipid pada Pasien Diabetes Melitus Tipe 2 dengan Kontrol Glikemik yang Terkendali dan Kontrol Glikemik yang Tidak Terkendali di RSUD Dr. Saiful Anwar Malang Conclusion. Type 2 DM patients with good glycemic control had significantly lower total cholesterol, triglycerides, and LDL-C levels compared to type 2 DM patients with poor glycemic control.
References
1. Zheng Y, Ley SH, Hu FB. Global aetiology and epidemiology of type 2 diabetes mellitus and its complications. Nat Rev Endocrinol. 2018;14(2):88-98.2. Hirano T. Pathophysiology of diabetic dyslipidemia. J Atheroscler Thromb. 2018;25(9):771-82.3. PERKENI. Pengelolaan dan pencegahan diabetes melitus tipe 2 di Indonesia. Jakarta: Perkeni; 2015.4. Sherwani SI, Khan HA, Ekhzaimy A, Masood A, Sakharkar MK. Significance of HbA1c test in diagnosis and prognosis of diabetic patients. Biomark Insights. 2016;11:95-104.178| Jurnal Penyakit Dalam Indonesia | Vol. 8, No. 4 | Desember 2021Nyoman Satvika Dharma Yudha, Putu Moda Arsana, Rulli Rosandi5. Verma M, Paneri S, Badi P, Raman PG. Effect of increasing duration of diabetes mellitus type 2 on glycated hemoglobin and insulin sensitivity. Indian J Clin Biochem. 2006;21(1):142-6.6. Alzahrani SH, Baig M, Aashi MM, Al-shaibi FK, Alqarni DA, Bakhamees WH. Association between glycated hemoglobin (HbA1c) and the lipid profile in patients with type 2 diabetes mellitus at a tertiary care hospital: a retrospective study. Diabetes Metab Syndr Obes. 2019;12:1639-44.7. Ozder A. Lipid profile abnormalities seen in T2DM patients in primary healthcare in Turkey: a cross-sectional study. Lipids Health Dis. 2014;13(1):183.8. Catapano AL, Graham I, De Backer G, Wiklund O, Chapman MJ, Drexel H, Hoes AW, Jennings CS, Landmesser U, Pedersen TR, Reiner Ž. 2016 ESC/EAS guidelines for the management of dyslipidaemias. Eur Heart J. 2016;37(39):2999-3058.9. Schofield JD, Liu Y, Rao-Balakrishna P, Malik RA, Soran H. Diabetes dyslipidemia. Diabetes Ther. 2016;7(2):203-19.10. Artha IM, Bhargah A, Dharmawan NK, Pande UW, Triyana KA, Mahariski PA, Yuwono J, Bhargah V, Prabawa IP, Manuaba IB, Rina IK. High level of individual lipid profile and lipid ratio as a predictive marker of poor glycemic control in type-2 diabetes mellitus. Vasc Health Risk Manag. 2019;15:149-57.11. Lally S, Tan CY, Owens D, Tomkin GH. Messenger RNA levels of genes involved in dysregulation of postprandial lipoproteins in type 2 diabetes: the role of Niemann–Pick C1-like 1, ATP-binding cassette, transporters G5 and G8, and of microsomal triglyceride transfer protein. Diabetologia. 2006;49(5):1008-16.12. Altmann SW, Davis HR, Zhu LJ, Yao X, Hoos LM, Tetzloff G, Iyer SP, Maguire M, Golovko A, Zeng M, Wang L. Niemann-Pick C1 Like 1 protein is critical for intestinal cholesterol absorption. Science. 2004;303(5661):1201-4.13. Phillips C, Owens D, Collins P, Tomkin GH. Microsomal triglyceride transfer protein: does insulin resistance play a role in the regulation of chylomicron assembly? Atherosclerosis. 2002;160(2):355-60.14. Hussain A, Ali I, Ijaz M, Rahim A. Correlation between hemoglobin A1c and serum lipid profile in Afghani patients with type 2 diabetes: hemoglobin A1c prognosticates dyslipidemia. Ther Adv Endocrinol Metab. 2017;8(4):51-7.15. Rader DJ, Hobbs HH. Disorder of lipoprotein metabolism. In: Kasper DL, Hause SL, Fauci AS, Longo DL, Jameson JL, Loscaizo J, editors. Harrison’s principles of internal medicine 19th edition. New York: McGraw Hill Education; 2015. p.2435-4916. Vergès B. Pathophysiology of diabetic dyslipidaemia: where are we? Diabetologia. 2015;58(5):886-99.17. Mullugeta Y, Chawla R, Kebede T, Worku Y. Dyslipidemia associated with poor glycemic control in type 2 diabetes mellitus and the protective effect of metformin supplementation. Indian J Clin Biochem. 2012;27(4):363-9
Recommended Citation
Yudha, Nyoman Satvika Dharma; Arsana, Putu Moda; and Rosandi, Rulli
(2021)
"Comparison of Lipid Profiles in Patients with Type 2 Diabetes Mellitus with Good Glycemic Control and Poor Glycemic Control in RSUD Dr. Saiful Anwar Malang,"
Jurnal Penyakit Dalam Indonesia: Vol. 8:
Iss.
4, Article 2.
DOI: 10.7454/jpdi.v8i4.592
Available at:
https://scholarhub.ui.ac.id/jpdi/vol8/iss4/2