Skip to main content
SpringerLink
Log in

Dyslipidemia Associated with Poor Glycemic Control in Type 2 Diabetes Mellitus and the Protective Effect of Metformin Supplementation

  • Original Article
  • Published:
Indian Journal of Clinical Biochemistry Aims and scope Submit manuscript

Abstract

The nature of the dyslipidemia associated with diabetes mellitus is complex and is the major risk factor for atherosclerosis and coronary artery disease. Aim of this study was to assess the effect of glycemic control, achieved by metformin, glibenclamide and insulin, on lipid profile in type 2 diabetic patients. One hundred and sixty-five type 2 diabetes mellitus patients were classified into good glycemic control (Group I) and poor glycemic control (Group II) on the basis of their blood HbA1c values. The Group II was characterized with high serum triglyceride (190.46 ± 15.20 mg/dl), total cholesterol (175.3 ± 6.31 mg/dl) as well as high LDL-cholesterol (109.0 ± 5.88 mg/dl). Significant correlations were evident between HbA1c and dyslipidemia, particularly serum TG (r = 0.28, P < 0.05), and between HbA1c and total cholesterol (r = 0.310, P < 0.05). Better glycemic control and improved dyslipidemia were observed in patients on combination therapy of metformin plus glibenclamide.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Gomes M, Gianella D, Faria M, Tambascia M, Fonseca R, Réa R, Macedo G, Filho J, Schmid H, Bittencourt A, Cavalcanti S, Rassi N, Pedrosa H, Atala S. Prevalence of Type 2 diabetic patients within the targets of care guidelines in daily clinical practice: a multi-center study in Brazil. Rev Diabet Stud. 2006;3(2):82–7.

    Article  PubMed  Google Scholar 

  2. Rizvi A, Sanders MB. Assessment and monitoring of glycemic control in primary diabetes care: monitoring techniques, record keeping, meter downloads, tests of average glycemia, and point-of-care evaluation. J Am Acad Nurse Pract. 2006;18:11–21.

    Article  PubMed  Google Scholar 

  3. Mooradian AD. Cardiovascular disease in type 2 diabetes mellitus: current management guidelines. Arch Intern Med. 2003;163:33–40.

    Article  PubMed  Google Scholar 

  4. Krauss RM. Lipids and lipoproteins in patients with type 2 diabetes. Diabetes Care. 2004;27:1496–504.

    Article  PubMed  CAS  Google Scholar 

  5. WHO. WHO model list of essential medicines. 16th ed. World Health Organization; 2010. p. 24. Available at www.who.int/medicines/publications/essentialmedicines/.

  6. Pfutzner A, Schondorf T, Tschope D, Lobmann R, Merke J, Muller J, Lehmann U, Fuchs W, Forst T. PIOfix-study: effects of pioglitazone/metformin fixed combination in comparison with a combination of metformin with glimepiride on diabetic dyslipidemia. Diabetes Technol Ther. 2011;13(6):637–43.

    Article  PubMed  Google Scholar 

  7. Bolen S, Feldman L, Vassy J, Wilson L, Yeh HC, Marinopoulos S. Systematic review: comparative effectiveness and safety of oral medications for type 2 diabetes mellitus. Ann Intern Med. 2007;147:386–99.

    PubMed  Google Scholar 

  8. Musi N, Hirshman MF, Nygren J, Svanfeldt M, Bavenholm P, Rooyackers O, Zhou G, Williamson JM, Ljunqvist M, Efendic S, Moller DE, Thorell A, Goodyear LJ. Metformin increases AMP-activated protein kinase activity in skeletal muscle of subjects with type 2 diabetes. Diabetes. 2002;51:2074–81.

    Article  PubMed  CAS  Google Scholar 

  9. Zander R, Lang W, Wolf HU. The determination of haemoglobin as cyanhaemiglobin or as alkaline haematin D-575. Comparison of method-related errors. J Clin Chem Clin Biochem. 1989;27(4):185–9.

    Google Scholar 

  10. Metus P, Ruzzante N, Bonvicini P, Meneghetti M, Zaninotto M, Plebani M. Immunoturbidimetric assay of glycated hemoglobin. J Clin Lab Anal. 1999;13(1):5–8.

    Google Scholar 

  11. Bianchi C, Penno G, Pancani F, Civitelli A, Piaggesi A, Caricato F, Pellegrini G, Del Prato S, Miccoli R. Non-traditional cardiovascular risk factors contribute to peripheral arterial disease in patients with type 2 diabetes. Diabetes Res Clin Pract. 2003;78(2):246–53.

    Article  Google Scholar 

  12. Betteridge DJ. Diabetic dyslipidaemia. Eur J Clin Invest. 1999;29(2):12–6.

    Article  PubMed  Google Scholar 

  13. Chahil TJ, Ginsberg HN. Diabetic dyslipidemia. Endocrinol Metab Clin North Am. 2006;35:491–510.

    Article  PubMed  CAS  Google Scholar 

  14. Feleke Y, Enquselassie F. An assessment of the health care system for diabetes in Addis Ababa, Ethiopia. Ethiop J Health Dev. 2005;19(3):203–10.

    Google Scholar 

  15. Kannel W, Gordon T, Castelli W. Obesity, lipids, and glucose intolerance. The Framingham Study. Atherosclerosis. 1993;102(1):63–7.

    Article  Google Scholar 

  16. Siraj ES, Seyoum B, Saenz C, Abdulkadir J. Lipid and lipoprotein profiles in Ethiopian patients with diabetes mellitus. Metabolism. 2007;55(6):706–10.

    Article  Google Scholar 

  17. Abdel-Gayoum AG. The effect of glycemic control in type 2 diabetic patients with diabetes-related dyslipidemia. Saudi Med J. 2004;25(2):207–11.

    PubMed  Google Scholar 

  18. Ceriello A, Kumar S, Piconi L, Esposito K, Giugliano D. Simultaneous control of hyperglycemia and oxidative stress normalizes endothelial function in type 1 diabetes. Diabetes Care. 2007;30(3):649–54.

    Article  PubMed  CAS  Google Scholar 

  19. Guerci B, Böhme P, Kearney-Schwartz A, Zannad F, Drouin P. Endothelial dysfunction and type 2 diabetes: altered endothelial function and the effects of treatments in type 2 diabetes mellitus. Diabetes Metab (Paris). 2001;27:436–47.

    CAS  Google Scholar 

  20. Hirano T, Mamo JC, Furukawa S, Nagano S, Takahashi T. Effect of acute hyperglycemia on plasma triglyceride concentration and triglyceride secretion rate in non fasted rats. Diabetes Res Clin Pract. 1990;9(3):31–8.

    Article  Google Scholar 

  21. Fujita Y, Fukushima M, Suzuki H, Taniguchi A, Nakai Y, Kuroe A, Yasuda K, Hosokawa M, Yamada Y, Inagaki N, Seino Y. Short-term intensive glycemic control improves vibratory sensation in type 2 diabetes. Diabetes Res Clin Pract. 2008;80(1):e16–9.

    Article  PubMed  CAS  Google Scholar 

  22. U.K. Prospective Diabetes Study. Plasma lipids and lipoproteins at diagnosis of NIDDM by age and sex. Diabetes Care. 1997;20:1683–1687.

    Google Scholar 

  23. Mohammadi H, Abdelouahed E-M, Hassar M, Bouchrif B, Qarbal B, Dahbi F, Hilal L, Ghalim N. Glycaemic control, HbA1c, and lipid profile in children with type 1 diabetes mellitus. Eur J Sci Res. 2009;29(2):289–94.

    Google Scholar 

  24. Mooradian AD. Dyslipidemia in type 2 diabetes mellitus. Nat Clin Pract Endocrinol Metab. 2009;5:150–9.

    Article  PubMed  CAS  Google Scholar 

  25. Nikkilä EA, Taskinen MR. Lipoprotein lipase of adipose tissue and skeletal muscle in human obesity: response to glucose and to semistarvation. Metabolism. 1981;30(8):810–7.

    Article  PubMed  Google Scholar 

  26. Adiels M, Olofsson SO, Taskinen MR, Boren J. Overproduction of very low density lipoproteins is the hallmark of the dyslipidemia in the metabolic syndrome. Arterioscler Thromb Vasc Biol. 2008;28:1225–36.

    Article  PubMed  CAS  Google Scholar 

  27. Khan AH. Clinical significance of HbA1c as a marker of circulating lipids in male and female type 2 diabetic patients. Acta Diabetol. 2007;44(4):193–200.

    Article  Google Scholar 

  28. Schwartz SL. Diabetes and dyslipidaemia. Diabetes Obes Metab. 2006;8(4):355–64.

    Article  PubMed  CAS  Google Scholar 

  29. Cook MN, Girman CJ, Stein PP, et al. UK Prospective Diabetes Study (UKPDS) Group. Glycemic control continues to deterio-rate after sulfonylureas are added to metformin among patients with type 2 diabetes. Diabetes Care. 2005;28:995–1000.

    Article  PubMed  CAS  Google Scholar 

  30. Krentz AJ, Bailey CJ. Oral antidiabetic agents: current role in type 2 diabetes mellitus. Drugs. 2005;65(3):385–411.

    Article  PubMed  CAS  Google Scholar 

  31. Wiernsperger NF, Bailey CJ. The antihyperglycemic effect of metformin: therapeutic and cellular mechanisms. Drugs. 1999;58:31–9.

    Article  PubMed  CAS  Google Scholar 

  32. Collier CA, Bruce CR, Smith AC, Lopaschuk G, Dyck DJ. Metformin counters the insulin-induced suppression of fatty acid oxidation and stimulation of triacylglycerol storage in rodent skeletal muscle. Am J Physiol Endocrinol Metab. 2006;291(1):E182–9. doi:10.1152/ajpendo.00272.2005.

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

The financial support from the Addis Ababa University, Ethiopia is dually acknowledged.

Author information

Authors and Affiliations

  1. Department of Biochemistry, Christian Medical College, Ludhiana, India

    Rajinder Chawla

  2. Department of Biochemistry, Faculty of Medicine, Addis Ababa University, Addis Ababa, Ethiopia

    Yonas Mullugeta & Yesehak Worku

  3. Department of Internal Medicine, Faculty of Medicine, Addis Ababa University, Addis Ababa, Ethiopia

    Tedla Kebede

Authors
  1. Yonas Mullugeta
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Rajinder Chawla
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Tedla Kebede
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Yesehak Worku
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Rajinder Chawla.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Mullugeta, Y., Chawla, R., Kebede, T. et al. Dyslipidemia Associated with Poor Glycemic Control in Type 2 Diabetes Mellitus and the Protective Effect of Metformin Supplementation. Ind J Clin Biochem 27, 363–369 (2012). https://doi.org/10.1007/s12291-012-0225-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12291-012-0225-8

Keywords

Search

Navigation