scholarly journals Study to find out the significance of postprandial dyslipidemia in diabetic patients

2021 ◽  
Vol 7 (1) ◽  
pp. 53-59
Author(s):  
Ayyali Ambresh ◽  
Ram Chaitanya K

: Diabetes Mellitus (DM) is a group of metabolic diseases, which is characterized by chronic hyperglycaemia, which results from the defects in the insulin action, insulin secretion or both. The most prevalent form of the disease, type 2 Diabetes Mellitus is often asymptomatic in the early stages and it may remain undiagnosed for many years.The insulin resistance in the liver leads to failure of the hyperinsulinaemia to suppress the gluconeogenesis, which increases fasting glucose levels and decreases. glycogen storage by the liver in the postprandial phase. Increased glucose production in the liver occurs early in the course of diabetes, and it is likely in skeletal muscles after the onset of the insulin secretory abnormalities and the insulin resistance. Due to the insulin resistance in the adipose tissue and obesity, the free fatty acid (FFA) flux from the adipocytes is increased, which in turn leads to an increase in lipid [very low-density lipoprotein (VLDL) and triglycerides] synthesis in the hepatocytes. This is responsible for the dyslipidaemia which is found in type2 diabetes mellitus [elevated triglycerides, reduced HDL, and increased low-density lipoprotein (LDL) particlesIndividuals with type 2 diabetes mellitus are at increased risk of developing microvascular and macrovascular complications.: To find out the significance of postprandial dyslipidemia in diabetic patients.: This is a cross-sectional study, wherein written informed consent was taken after giving detailed information to the participants regarding the study. Patients who were in the age group of 35-65 years, admitted in the Department of Medicine, RRMCH from November 2017 for next 18 months with Diabetes Mellitus who met a predefined inclusion and exclusion criteria were studied. The study was initiated after obtaining clearance from the institution's ethical committee.: There was a significant elevation of mean values of total serum cholesterol, LDL and TG of cases and controls in the postprandial state compared to their fasting state, statistical significance was found (P<0.05).Mean values of total serum cholesterol, LDL and TG of cases in fasting state were significantly more compared to controls in fasting state, statistical significance was found (P<0.05).Mean values of total serum cholesterol, LDL and TG of cases in the postprandial state were significantly more compared to controls in the postprandial state, statistical significance was found (P<0.05).Mean values of both FBS and PPBS in cases were higher compared to controls (P<0.05). Mean values of PPBS in cases and controls were significantly more compared to their respective FBS values (P<0.05).The mean HbA1c values in cases were higher(7.142) compared to controls (5.554).: Prevalence of diabetes was highest in the age group 56-65 years in our hospital.As the duration of diabetes increases, there is an increased prevalence of dyslipidemia in the cases.Past history of HTN, IHD, PVD and CVA were found significantly more in subjects with fasting and postprandial dyslipidemia (cases) compared to those without(controls).Patients on irregular treatment (63%) were more in the study group(cases) compared to controls. So it could be said that patient not on regular treatment are more prone to have dyslipidemia. (fasting as well as postprandial). There was a significant increase in total serum cholesterol, LDL and TG in postprandial states of cases compared to that in controls, so it could be said that diabetic patients with fasting dyslipidemia are more prone to have dyslipidemia in the postprandial state.

2021 ◽  
Vol 7 (1) ◽  
pp. 45-52
Author(s):  
Ayyali Ambresh ◽  
Ram Chaitanya K

In the modern world, the growing incidence of type 2 diabetes mellitus (T2DM) is a critical problem. In type 2 DM, abnormal lipid profile in the postprandial state has more significance than abnormal lipid profile in fasting state in causing atherosclerotic complications. The high cardiovascular morbidity and mortality in type2 DM are due to prolonged postprandial hyperglycemia and triglyceridemia. Postprandial hypertriglyceridemia results in a proatherogenic environment which leads to atherosclerosis and macrovascular complications in type 2 diabetes mellitus. It is believed that atherosclerosis is a postprandial phenomenon with respect to lipids, as we are in the postprandial state for most of the day.It is not clearly known whether diabetic patients with macrovascular disease have greater abnormalities of postprandial TG metabolism than those without.Hence this study is being carried out to find out the characteristics of post prandial lipid levels in patients with type 2 diabetes mellitus and itsimpact on macrovascular complications.: To study fasting & postprandial lipid abnormality in type 2 DM patients in comparison to controls.: This is a cross-sectional study, wherein written informed consent was taken after giving detailed information to the participants regarding the study. Patients who were in the age group of 35-65 years, admitted in the Department of Medicine, RRMCH from November 2017 for next 18 months with Diabetes Mellitus who met a predefined inclusion and exclusion criteria were studied. The study was initiated after obtaining clearance from the institution's ethical committee.: There was a significant elevation of mean values of total serum cholesterol, LDL and TG of cases and controls in the postprandial state compared to their fasting state, statistical significance was found (P<0.05). Peripheral vascular disease in our study was found in 25 patients i.e.25% of the study group. In cases, it was found in 20 patients and in controls, it was found in 5 patients i.e. 40% and 10% respectively. The occurrence of PVD was more in cases compared to controls with statistical significance(p<0.05). Stroke in our study is found in 7 patients i.e. 7% of the study group. In cases, it was found in 6 patients and in controls, it was found in 1 patient i.e. 12% and 2% respectively. The occurrence of CVA was more in cases compared to controls with statistical significance(p<0.05). Ischemic strokes were more common than haemorrhagic strokes.: Patients on irregular treatment (63%) were more in the study group(cases) compared to controls. So it could be said that patient not on regular treatment are more prone to have dyslipidemia. (fasting as well as postprandial). There was a significant increase in total serum cholesterol, LDL and TG in postprandial states of cases compared to that in controls, so it could be said that diabetic patients with fasting dyslipidemia are more prone to have dyslipidemia in the postprandial state. This study concluded that all macrovascular complications (IHD, CVA, PVD) were found more in the case compared to controls with statistical significance. So it could be said that there is an increase in the occurrence of macrovascular complications with an increase in postprandial dyslipidemia.


1982 ◽  
Vol 28 (1) ◽  
pp. 5-8 ◽  
Author(s):  
R Schaffer ◽  
L T Sniegoski ◽  
M J Welch ◽  
V E White ◽  
A Cohen ◽  
...  

Abstract Isotope dilution/mass spectrometric methods for total serum cholesterol, developed separately at the Karolinska Institutet (KI) and the National Bureau of Standards (NBS), were compared by applying them to a common set of serum pools. A search for the cause of a systematic difference of a few percent in results from the two methods revealed that the KI cholesterol standard contained lathosterol, which interfered with the calibration of the method. With NBS Standard Reference Material cholesterol used for new analyses at the KI, the average difference in mean values dropped to 0.2%. The NBS results are more precise. This is attributed to the protocols NBS used for sample preparation and mass spectrometry. However, these protocols make the NBS method more complex and time-consuming. A recent critical article on the use of this technique for total cholesterol is also examined.


2021 ◽  
Vol 8 (39) ◽  
pp. 3411-3416
Author(s):  
Sneha Varikkaatu Prasanna ◽  
Prasantha Kumar Thankappan

BACKGROUND Type 2 diabetes mellitus (DM) is characterized by insulin resistance which is associated with glucose intolerance, hypertension, dyslipidaemia, a procoagulant state, and an increase in the microvascular and the macrovascular disease. The high cardiovascular mortality which is associated with type 2 DM is due to a prolonged, exaggerated, postprandial state. The abnormal lipid profile in the postprandial state is more significant than the abnormal lipid profile in the fasting state in causing atherosclerotic complications in type 2 diabetes. Very few studies are available on the estimation of the postprandial lipid profile in type 2 diabetes patients. The purpose of this study was to compare fasting and postprandial lipid levels among patients with and without diabetes mellitus and find out the correlation between duration of detection of diabetes mellitus and postprandial lipid levels among patients with diabetes mellitus. METHODS This is a cross sectional analytical study of a study population of 200 subjects including in patients and out patients of wards and diabetic clinic of Government Medical College, Kottayam from April 2017 to March 2018. Data was coded and entered in Microsoft Excel and IBM Statistical Package for Social Sciences (SPSS version 22) for statistical analysis. RESULTS Diabetic patients had impaired fasting and postprandial lipid profiles. Impairment in postprandial lipid profile when compared to non-diabetics was statistically significant. Duration of detection of diabetes and postprandial lipid levels showed weak positive correlation. CONCLUSIONS The postprandial lipid profile in diabetes mellitus patients is significantly deranged compared to fasting state and is an important factor in assessing their cardiovascular risk. Hence, there is a need to stress on postprandial lipid profile estimation in diabetic patients. KEYWORDS Fasting Lipid Profile, Postprandial Lipid Profile, Type 2 Diabetics, Nondiabetics


KYAMC Journal ◽  
2013 ◽  
Vol 2 (1) ◽  
pp. 123-127
Author(s):  
Md Manzurur Rahman Shah Choudhury ◽  
Towhidul Alam ◽  
AKM Shahidur Rahman

Diabetes mellitus is a global health problem and is associated with abnormalities of lipids and lipoprotein metabolism in variable frequency. The aim of the present work was to study the lipid abnormalities in NIDDM patients. Dyslipidaemia is of special interest because to compare it between male and female NIDDM patients and as well as to see the impact between women of reproductive age group and post menopausal women. For this purpose total serum cholesterol, triglyceride, LDL-C, HDL-C and LDL/HDL ratio were determined of a total number of 160 subjects. Out of these 80 subjects were diabetic and 80 were non-diabetic control subjects of both sexes. In this study, the total serum cholesterol levels were higher in NIDDM than control subjects and showed significant statistical difference (P<0.05) between control and NIDDM subjects. The serum triglyceride levels were found higher amongst diabetics as compared to the normal healthy controls and showed statistically significant difference (P<0.05). Higher LDL-C levels were showed in NIDDM and revealed significant difference (P<0.05) in comparison to control non-diabetic subjects and NIDDM patients. HDL-C levels were found decreased in patients with NIDDM compared to controls. The findings in the patients with NIDDM between male and female revealed no significant difference (P>0.05) in mean TC, TG, HDL-C and LDL-C between male and female diabetic patient in unpaired t-test. With improvement of diabetic control some improvement of the lipid abnormalities can be achieved. Most studies have shown that improvement of lipid abnormalities occur with proper glycaemic control in patients with NIDDM. The atherosclerotic process in the diabetic patient is indistinguishable from that seen in the non-diabetic population but it begins earlier and is more severe. Risk factors associated with atherosclerosis in the non-diabetic subject appear to have a similar relation to coronary heart disease among diabetics. Further studies are necessary to confirm the present suggestions, studies involving more number of subjects, estimation of Hb AIC.DOI: http://dx.doi.org/10.3329/kyamcj.v2i1.13516 KYAMC Journal Vol.2(1) 2011 pp.123-127


2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Anoop Shankar ◽  
Srinivas Teppala

Background. Bisphenol A (BPA) is a common chemical used in the manufacture of polycarbonate plastics and epoxy resins, with >93% of US adults having detectable BPA levels in urine. Recent animal studies have suggested that BPA exposure may have a role in several mechanisms involved in the development of hypertension, including weight gain, insulin resistance, thyroid dysfunction, endothelial dysfunction, and oxidative stress. However, no previous human study has examined the association between markers of BPA exposure and hypertension.Methods. We examined urinary BPA levels in 1380 subjects from the National Health and Nutritional Examination Survey 2003-2004. Main outcome-of-interest was hypertension, defined as blood pressure-reducing medication use and/or blood pressures >140/90 mm of Hg (n=580).Results. We observed a positive association between increasing levels of urinary BPA and hypertension independent of confounding factors such as age, gender, race/ethnicity, smoking, body mass index (BMI), diabetes mellitus and total serum cholesterol levels. Compared to tertile 1 (referent), the multivariate-adjusted odds ratio (95% confidence interval) of hypertension associated with tertile 3 was 1.50 (1.12−2.00);P-trend = 0.007. The association was consistently present in subgroup analyses by race/ethnicity, smoking status, BMI, and diabetes mellitus.Conclusions. Urinary BPA levels are associated with hypertension, independent of traditional risk factors.


1993 ◽  
Vol 128 (3) ◽  
pp. 251-258 ◽  
Author(s):  
Per H Andersen ◽  
Bjørn Richelsen ◽  
Jens Bak ◽  
Ole Schmitz ◽  
Niels S Sørensen ◽  
...  

In a short-term (eight days) double-blind crossover study involving 10 obese patients, the effects of dexfenfluramine on glucose and lipid metabolism were examined. The protocol comprised whole body in vivo measurements (hyperinsulinemic euglycemic clamp in combination with indirect calorimetry) and in vitro studies of isolated adipocytes (lipolysis and glucose transport). All study participants were weight stable during the study period (103.1±3.2, placebo vs 103.3±3.1 kg, dexfenfluramine, NS). The following parameters were significantly reduced after dexfenfluramine treatment: fasting levels of plasma glucose (6.2±0.2 vs 5.7±0.2 mmol/l, p<0.01), serum insulin (168.0±14.5 vs 138.9±7.9 pmol/l, p<0.05), serum C-peptide (0.68±0.03 vs 0.58±0.02 nmol/l, p<0.05) and total serum cholesterol (6.07±0.41 vs 5.48±0.38 mmol/l, p< 0.01). In the basal state glucose oxidation rate was significantly reduced by 36% (p<0.001), whereas non-oxidative glucose disposal was significantly increased by 41% (p<0.01), following dexfenfluramine treatment. Insulin-stimulated (2 mU·kg−1·min−1) glucose disposal rate tended to be increased (18%, p=0.10) after dexfenfluramine. In conclusion, dexfenfluramine possesses beneficial regulatory effects on glucose and lipid metabolism in non-diabetic obese patients, independently of weight loss.


Author(s):  
Mr. Kedar Prasad Yadav ◽  
Dr. Ricky Mittal

INTRODUCTION: Diabetes mellitus (DM) is a group of metabolic disorder which is characterized by increase blood glucose level resulting from defects in insulin secretion, insulin action or both and disturbances of carbohydrate, lipid and protein metabolism. Worldwide With an increasing incidence of DM may be a likely leading cause of morbidity and mortality in the future[i]. It is well known that dyslipidemia is a major risk factor for macrovascular complications with type-2 diabetes mellitus (T2DM) which affects 10%-73% of this population. It is well known that dyslipidemia is a major risk factor for macrovascular complications with type-2 diabetes mellitus (T2DM) which affects 10%-73% of this population. Dyslipidemia, hyperglycemia and hyperlipidemia are results of Insulin resistance and obesity combine cause and have additive cardiovascular risk. Therefore identification, critical evaluation and follow-up of serum lipid profile is important in DM continuously.  One of the study showed that prevalence of dyslipidemia in diabetes mellitus is 95%. Major risk factor for Coronary Heart Disease is dyslipidemia. In DM patients cardiovascular disease is a cause of morbidity and mortality because of disturbance in lipoproteins i.e. serum triglycerides (TC) 69%, serum cholesterol 56.6%, Low Density Lipoprotein cholesterol (LDL) 77% and High Density Lipoprotein cholesterol (HDL) 71%. AIM: The main aim of this study is to know the lipid profile in Diabetics mellitus (DM). MATERIAL AND METHODS: Total 100 patients with DM were included in this study during the period of 1 year. During the study period 100 normal healthy people without DM were also included as control study. From all the patients detail histories were taken as well as relevant clinical examination with routine investigations were also done. All the patients were for at least 12-14 hours overnight fasting and 5ml venous blood was collected in a disposable syringe on next morning (before breakfast) for the serum lipid profile and fasting blood sugar. RESULT: In this study out of 100 diabetic patients 48 (48%) were males and 52 (52%) were females. 70% of DM patients showed high serum cholesterol level and all persons had normal serum cholesterol level in control group. 75% of DM patients showed high serum triglyceride level (>150mg/dl).  39% of DM patients showed Serum LDL level was high (>160 mg/dl). 85% of DM patients showed low (<40 mg/dl) serum HDL value. CONCLUSION: In DM patients lipid abnormalities in diabetes are raised serum cholesterol, raised triglycerides, and raised serum LDL and low serum HDL. Therefore there is important impact of dyslipidemia on cardio vascular complications required complete attention throughout the course of disease. Hence early screening of diabetic patients for dyslipidemia and intervention is necessary to minimize the risk of cardiovascular diseases. KEYWORDS: Diabetes mellitus (DM), dyslipidemia, cholesterol, triglyceride   Diabetes: facts and figures [Internet]. International Diabetes Federation. [cited 2016Jul14].


Sign in / Sign up

Export Citation Format

Share Document