Diabetic dyslipidemia: prevalence, clinical characteristics and association with glycemic control among diabetic patients in Dar es Salaam

Abstract

Background

Diabetes is a major healthcare problem, by 2010 there will be approximately 221

million people with diabetes worldwide. Diabetes is associated with quantitative and

qualitative changes in lipoproteins. Correcting lipoprotein abnormalities reduces the

coronary risk in diabetes.

Objective

To determine the prevalence, clinical characteristics and association between

dyslipidemia and glycaemic control among diabetic patients in Dar es Salaam.

Methodology

A descriptive cross-sectional study was conducted between November 2006 and

January 2007. A total of 150 diabetic patients aged 18 years and above who were

attending the diabetic clinics at Muhimbili National Hospital, Amana, Temeke and

Mwananyamala Municipal Hospitals were recruited into the study. These patients were

selected by simple random sampling, interviewed using a structured questionnaire,

physically examined and then investigated for fasting lipid profiles and glycated

hemoglobin`using KonelabTM (@ 2003 Thermo Electron Corporation) machine. Chi-

square tcsL Student`s t-test and multiple logistic regressions were used for data analysis.

Ap-value of < 0.05 was taken to be statistically significant.

Results

The prevalence of dyslipidemia was found to be 94.7%, with the commonest derangement being elevated triglyceride levels in 94.7% (142/150), Dyslipidemia presented clinically as angina 11.3% (17/142), peripheral vascular disease 2.1% (3/142)

and corneal arcus 21.8% (31/142). In a multivariate analysis, poor glycaemic control as

determined by measurement of glycated hemoglobin was found to be independently

associated with dyslipidemia (p - 0.036).

Conclusion and Recommendation

The prevalence of dyslipidemia among diabetic patients in Dar es Salaam is high.

Because risk factors for heart disease are additive and even multiplicative, mild degrees

of dyslipidemia may increase CUD risk. Therefore, controlling dyslipidemia should be

given equal emphasis as controlling hyperglycemia when developing strategies for

managing diabetes