scholarly journals Correlation of fasting and postprandial dyslipidemia with macrovascular complications of diabetes mellitus

2021 ◽  
Vol 7 (1) ◽  
pp. 60-68
Author(s):  
Ayyali Ambresh ◽  
Ram Chaitanya K
Keyword(s):  
Diabetes Mellitus ◽  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Statistical Significance ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Macrovascular Complications ◽  
Study Group

: 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 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. 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) particle.Individuals with type 2 diabetes mellitus are at increased risk of developing microvascular and macrovascular complications. Increased postprandial glucose (PPG) concentrations contribute to suboptimal glycemic control. : To correlate fasting and postprandial dyslipidemia with macrovascular complications of diabetes.: 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.: IHD changes were found in 8 cases and 3 controls, LVH by voltage criteria was found in 15 cases and 8 controls. IHD changes found in cases and controls are 16% and 6% respectively. LVH changes found in cases and controls are 30% and 16% respectively.Abnormal 2D Echo findings in our study were mainly IHD and LVH. The occurrence of IHD was more in cases compared to controls with statistical significance(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. : It could be said that there is an increase in the occurrence of postprandial dyslipidemia with increasing age, irregular treatment, increase in HbA1c, FBS ,PPBS and with the past history of HTN, CVA, PVD and IHD.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.

scholarly journals Bariatric surgery as a model to explore the basis and consequences of the Reaven hypothesis: Small, dense low-density lipoprotein and interleukin-6

2019 ◽  
Vol 16 (2) ◽  
pp. 144-152 ◽  
Author(s):  
Safwaan Adam ◽  
Yifen Liu ◽  
Tarza Siahmansur ◽  
Jan H Ho ◽  
Shaishav S Dhage ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
Bariatric Surgery ◽  
Type 2 Diabetes Mellitus ◽  
Interleukin 6 ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Low Density

Background: Reaven originally described the clustering of insulin resistance/hyperinsulinaemia, obesity (particularly visceral), altered cytokine levels, glucose intolerance, hypertriglyceridaemia and low high-density lipoprotein cholesterol. Subsequently, a potentially highly atherogenic small, dense low-density lipoprotein was also reported. We have studied the effect of bariatric surgery on this and other risk factors for atherosclerosis. Methods: Forty patients (20 with type 2 diabetes mellitus) undergoing bariatric surgery were studied before and 1 year after bariatric surgery. Results: Twelve months after bariatric surgery, median body mass index had decreased from 49.5 to 36.5 kg/m2, fasting insulin from 21.3 to 7.8 mU/L and insulin resistance (homeostatic model assessment of insulin resistance) from 5.9 to 1.8 (all p < 0.001). Thirteen out of 20 patients had remission from type 2 diabetes mellitus. Highly sensitive C-reactive protein, interleukin-6, fasting triglycerides ( p < 0.001) and small, dense low-density lipoprotein ( p < 0.001) decreased, while high-density lipoprotein cholesterol increased ( p < 0.001) significantly, irrespective of having type 2 diabetes mellitus and/or being treated with statin therapy before surgery. Conclusion: The association between marked weight loss and change in insulin resistance and hyperinsulinaemia with the change in small, dense low-density lipoprotein and interleukin-6 warrants further investigation. Bariatric surgery provides a model for investigating the mechanisms linking insulin resistance/hyperinsulinaemia to atherosclerosis.

scholarly journals Study of fasting and post prandial lipid abnormalities in type 2 diabetes mellitus in comparison to controls

2021 ◽  
Vol 7 (1) ◽  
pp. 45-52
Author(s):  
Ayyali Ambresh ◽  
Ram Chaitanya K
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Statistical Significance ◽  
Macrovascular Complications ◽  
Total Serum ◽  
Diabetic Patients ◽  
Study Group ◽  
Postprandial State

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&#60;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&#60;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&#60;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.

scholarly journals Evaluation of dyslipidemia in type 2 diabetes mellitus

2015 ◽  
Vol 6 (6) ◽  
pp. 16-19 ◽  
Author(s):  
Devendra Pratap Singh Rajput ◽  
Javed Yusuf Shah ◽  
Priti Singh ◽  
Shyransh Jain
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Lipid Profile ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Serum Triglyceride ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients

Back ground: In type 2 diabetes mellitus lipid abnormalities are almost the rule. Dyslipidemia has been noted to play an integral role in the pathogenesis and progression of micro and macrovascular complications in diabetes mellitus patients. The complications exemplified by renal, cerebrovascular and cardiovascular disease cause the most morbidity and mortality in this group of patients.Aims and Objectives: This study is aimed at understanding the pattern of dyslipidemia among type 2 diabetic patients. Materials and Methods: During two month study period, total 100 patients with diabetes mellitus were evaluated for dyslipidemia. Plasma glucose was estimated by GOD –POD method and Lipid profile by photometry method. Lipid profile was evaluated by investigating the subjects for total cholesterol, serum triglyceride, high density lipoprotein, low density lipoprotein and very low density lipoprotein. In statistical analysis data were analyzed by using various statistical methods like percentage, proportions and tables by using epi info software.Results: Out of 100 patients 72(72%) were males and 28(28%) were females. The mean  fasting blood sugar of total patients with type 2 diabetes mellitus was 158.35mg/dl. in male diabetics, fasting blood sugar level with diabetes mellitus was 157.56mg/dl and in female diabetics it was 159.14mg/dl. The pattern of dyslipidemia in our study showed significantly higher levels of serum cholesterol, serum triglyceride, LDL-C in both male and female diabetics and lower levels of HDL-C in female diabetics. There was no significant difference in lipid profile pattern in male and female diabetic patients except lower levels of HDL-C in female diabetic patients. Conclusion: This study showed that dyslipidemia is highly prevalent among type 2 diabetic patients. DOI: http://dx.doi.org/10.3126/ajms.v6i6.12452Asian Journal of Medical Sciences Vol.6(6) 2015 16-19                                     

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