Configuration of dyslipidemia in patients with type 2 diabetes mellitus visiting tertiary care hospital Quetta-Pakistan

Dyslipidemia among others, is the profound threat for cardiovascular disorder in Type 2 Diabetes Mellitus (DM). Prompt recognition and management of dyslipidemia in Type 2 DM can inhibit threats for atherogenic heart disease. The motivation behind the upcoming study was to uncover the irregularity of lipid profiles in Type 2 DM patients. Requisite statistics were taken from 242 patients (95 females, 147 male) suffering with Type 2 DM and registered in the Department of Endocrinology and Medicine at Bolan Medical Complex hospital (BMCH) and Sandeman Provincial Hospital (SPH) Quetta, Pakistan. The Result of lipid profiles indicated that statistical values for Total Cholesterol (TC), Triglyceride (TG), High Density Lipid Cholesterol (HDL-C), Low Density Lipid Cholesterol (LDL-C) and Very Low Density Lipid Cholesterol were (VLDL-C) 196.03 ± 67.99, 256.69 ±173.56, 36.11 ±9.95,118.29 ± 56.41 and 49.80 ± 33.44 mg/dl in female subjects respectively. In male subjects the mean-values for TC, TG, HDL-C, LDLC and VLDL-C were 222.12 ± 69.24, 339.37 ± 260.73, 34.73 ± 7.10, 119.08± 42.10 and 68.46 ± 54.42 mg/dl respectively. FPG demonstrated profoundly positive correlation with RPG. TG displayed a profoundly negative correlation with HDL, while positive correlation with VLDL, but HDL showed negative statistical correlation with LDL. The study disclosed communal lipid irregularities during diabetes prompted dyslipidemia i.e., elevated TC, TG, LDL-C and decreased HDL-C values. This abstraction advocates prevalence of hyperlipidemia over increased dominance of dyslipidemia.


Introduction
Pakistan is the 6 th densely populated Country of the world [1].In Pakistan, most people live in rural areas.Pakistan has tolerated deteriorated economic and epidemiologic alteration.Accelerating urbanization has directed to deskbound lifestyle, enhanced calorie food intake, greedy eating and less consuming.The said irritating habits doubled with the stressful conditions led towards the occurrence of Type 2 DM [2].Type 2 DM is placed high amongst the top ten globally health emergencies worldwide, moreover is also placed amongst the top ten reasons of mortalities and combined with the other three most important Non  of age were included.Subjects meeting the inclusion criteria were briefed about the study and informed consent was obtained from those agreeable to participate.Study participants were interviewed by a direct interview and the information was entered in a semi-structured questionnaire to get the following details: demographic characteristics and Using patients' clinic files, the following clinical data were recorded.i.e.FPG, RBG, HbA1C, lipid profile and other measures.1. Group A consisted of female T2 DM 2. Group B consisted of male T2 DM Group A and B patients were diagnosed cases of T2 DM.Patients were selected on the basis that there was no significant difference in their clinical characteristics and glycemic status.One hundred forty-seven (147) patients were males and ninety-five (95) patients were females.

Exclusion criteria
Patients were excluded from the study on the following conditions: 1.If they were less than 18 year of age, had T1DM, GDM, and steroid induced diabetes.2. Patients suffering from other causes of secondary dyslipidemia such as hypothyroidism, cystic fibrosis, patients taking contraceptives.

Statistical analysis
Statistical analysis was performed using the statistical package for the social sciences (SPSS) software version 23.Descriptive analysis was used to analyze the demographic data.The descriptive statistic included mean, median, frequency and standard deviation.The data were analyzed Correlative studies (Person's correlation) that executed between the variables of FPG, RPG and lipid profile (TC, TG, HDL-C, LDL-C& VLDL-C) by using SPSS.

Results
In this study, type 2 DM patients (n=242) were included comprising of adult male (n=147) and adult female (n=95) patients (Table 1) Female patients, the age range and mean age were 23-76 years and female patients mean age 48.45 ± 12.42, whereas in male patients the age range and mean age were 25-78 years and 48.10 ± 12.79 years, respectively.Outcomes of the blood glucose level (Table 2) revealed that all patients were hyper glycemic.In female patients FPG statistical range and mean-value were 73-410 mg/dl and 171.56± 68.17 mg/dl, whereas in female patient's RPG statistical range and mean value were 148-551 mg/dl and 284.37 ± 104.72mg/dl.The consequent outcome displayed the FPG in male patients, the statistical range and mean-value were 67-418 mg/dl and 167.85 ± 60.44 mg/dl, whereas in males; the range and mean-value of RPG were138-594 mg/dl and 279.63 ±104.85 mg/dl respectively (

Table 4 . Statistical Correlation between FPG, RPG, TC, TG, HDL, LDL, VLDL
The low levels of HDL-C with its uncomplimentary compositional variations.Co-occurrence of the said features strongly magnifies the lipid gathering in arterial vessels and the plaque constitution [

20, 21].
American Diabetes Association (ADA) and European Association for the Study of Diabetes (EASD) combined scientific statement advocates Lifestyle administration (includes healthy diet, physical activities and quitting the smoking) as a first tool for the managing of Type 2DM, with objectives of weight reduction and decrease of cardiovascular hazards [14].Physical activities are significant in the avoiding the development of Type 2DM in patients with IGT, and for the regulation of glucose level and interrelated CVD problems [15].Aerobic and resistance exercise ameliorate insulin